When we enter the second pandemic winter, should you still use the cloth masks you bought in 2020?

The weather is getting cooler, the holidays are approaching, and the pandemic is still with us. Of course, your 5-11-year-old child is about to receive the first dose of vaccine, but many experts warn that we are in the control mode of this virus and will not disappear from the spread anytime soon. This means that we all have school and family gatherings indoors, and Covid is still spreading. Dr. Tom Russo, Professor of Infectious Diseases at the University of Buffalo, said that if your child (and you) is still wearing the cloth mask you purchased in April 2020, then it’s time to reconsider.

Upgrading masks is not only a personal risk assessment, but also has a broader public health impact. This depends on a family's risk tolerance, medical vulnerability, local transmission and mask demand, as well as the availability of high-quality masks and the resources to obtain them. Compared with the beginning of the pandemic, we now know more about masks and their importance. Unfortunately, there is still a wide range of official recommendations, competing expert recommendations, and potential quality inconsistencies. These factors combine to make people feel frustrated and worried about the mask decision.

New standards have been issued to ensure the consistency of masks. Some experts recommend the use of respirators. This type of respirator is now more widely used and may have fewer trade-offs compared to previously available models. (More on below.)

For anyone 5 years and older, vaccination is the best way to protect. But many schools still need masks, and they greatly reduce the need for isolation. As long as the positive cases and other students wear masks, the CDC will not treat these children as "close contacts," so they may not have to miss school due to isolation.

Daniele Lantagne, a public health engineer at Tufts University, has worked with CDC on public health interventions and currently advises WHO on mask guidance. She wears a respirator mask when she teaches college students so that there are positive cases in her class. Neither she nor her unvaccinated children need to be isolated.

So far, the scientific consensus is clear: one person becomes infected with Covid-19 by inhaling infectious particles from another person. Cloth masks and surgical masks do a better job of blocking larger and heavier particles, and "breathing masks"-KF94, N95, and KN95-are designed to filter particles that remain in the air for a long time.

The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) do not recommend normal people (that is, non-frontline workers) to wear gas masks during daily activities. However, some physicists and aerosol scientists, especially Lindsay Marr of Virginia Tech, believe that these masks should be worn more widely to prevent the spread of Covid-19.

Although no one questioned the role of breathing masks, they have traditionally been tested and worn in controlled environments such as hospitals or laboratories. The traditional view is that these masks are so impractical in the real world that their improper use will offset any benefits of their more effective filtering. They need to be properly sealed around the face so that all incoming air passes through the filter media. They may have difficulty breathing, making them uncomfortable for a long time.

Lantagne said children should not be forced to wear suitable respirator masks. If the boat shape of the KN94 is more comfortable for children, they should wear it without pinching the nose pads in order to breathe more easily.

However, aerosol scientist Aaron Collins said that the old assumption that breathing masks are always uncomfortable is outdated. KF94 is a popular standard in South Korea, with a comfortable and breathable formula, suitable for daily wear.

Collins tested dozens of masks in his spare time. He runs the Twitter account Masknerd and publishes his test on Youtube for people to follow. He said that his tests have repeatedly shown that good KF94, N95 and KN95 are easier to inhale than high-quality cloth masks, three or four layers and filters (not the kind you bought back in April 2020).

"The argument why I should use these masks is because we have this technology," Collins said. "There is no reason not to use them." Collins said that most people he knows who wear masks for a long time switch to high-quality KF94. "They are comfortable. They provide excellent protection for yourself and others," he said. "So this is a victory, a victory, a victory."

Laboratory test data does not always translate into real-world functions. A randomized controlled trial in Bangladesh that is currently undergoing peer review found that surgical masks perform better than cloth masks. The WHO still recommends the non-medical community to use appropriately made cloth masks. Although the Bangladesh study may prompt people to reconsider medical masks, “the community does not recommend the use of respirators,” Lantagne said.

"The data we have about the filtration efficiency, efficacy, or effectiveness of the actual community environment rarely involves children, especially children under 12 years old," Lantagne said. "We have a huge data graph gap in the operational efficiency of masks and the effectiveness of masks for children in the community environment."

Experts agree that the best mask is one that you or your child can wear comfortably when needed. High-filter respirators that schools cannot tolerate are not effective masks. The mask should be close to the face and cover the nose, mouth and chin seamlessly. Many children need to wear masks throughout school and take occasional breaks during lunch or possibly outside. Masks that children cannot or do not want to wear are invalid

It would be great if the children's KF94 or N95 fits and is comfortable. If not, Russo said, "Keep on until you find a method that suits them."

Not every child, even the same family, can wear the same mask. The father of Iowa City, Jeremiah Kurth, witnessed this with his own eyes. One of his 5-year-old twins only wears a dinosaur cloth mask, while the other wears a child-sized KN95. His 13-year-old is wearing adult KN95.

Masks are a thriving niche market-a research report earlier this year predicted that the mask market will grow to nearly $32 billion by 2027-and innovators are scrambling to fill this gap.

If your child is wearing a cloth mask, it should meet ASTM's "barrier mask" standard. A similar standard is the way in which medical masks are supervised. Lantagne said that they are an important step in the standardization of cloth masks. All three experts pointed out that one advantage of medical or respiratory masks is that they are consistent products, while the performance of cloth masks has some uncertainty.

These are not cheap. High-end cloth masks like Enro cost $16.50 per mask, and children who go to school may need at least two or three. Baggu's set of three fabric masks, only two layers thick (so Russo does not recommend them), sells for $32. The retail price of disposable children's KF94 masks ranges from US$0.70 to US$3 per mask, some of which are very cute. Collins says they can be worn for up to 40 hours without reducing effectiveness. He spun them a bit, letting them ventilate between wearing.

Lantagne has allowed her to live peacefully with the masks worn by her children, as well as the necessary risks inherent in school and work during the pandemic. "We prioritize education, socialization and [and] mental health. We do our best to prevent Covid," she said.

Dr. Tom Russo, Professor of Infectious Diseases, University of Buffalo

Daniele Lantagne, Public Health Engineer, Tufts University