Michigan Association of Health Plans

Omicron requires a better mask. How to choose one that’s best for you.

This article appeared in Bridge. Read more here. 

With the spread of the omicron variant, federal health officials are urging people to wear higher-quality masks — the most effective being N95s, if you can tolerate them, while details are forthcoming on a federal program to make masks available to more Americans.

On Friday, the U.S. Centers for Disease Control and Prevention updated its guidance on masks — responding to pressure to do so in recent weeks as omicron overwhelms hospitals, worsens worker shortages, complicates efforts to return to a normal school year, and overtakes the ability to track community spread.

While finding the right mask involves some consumer sleuthing to avoid counterfeits, two messages are now clear: Avoid cloth masks if at all possible. And the best mask for you is the highest-quality mask you are willing to wear consistently.

And we’re here to help you navigate the differences between various, higher-quality masks, and point you to resources that will help you avoid counterfeits.

The CDC stopped short of specifying which mask to use, but makes clear that N95s and similar high-filtration respirators such as the KN95 offer the “best protection” against COVID-19. The government previously declined to recommend these top-level masks to the public in order to prioritize limited supplies for workers in healthcare settings.

In addition, noting that the N95 mask has yet been approved for children, the CDC urged parents to search for a “well-fitting and comfortable mask or respirator that your child can wear properly.”

“A lot of people have said, now it’s time for people to be wearing better masks — the N95 type of masks, and they may be right,” said Dr. Matthew Sims, head of infectious diseases research for Beaumont Health and one of the first researchers to test the effectiveness of masks against COVID.

But Sims also noted that “it’s not easy to wear an N95 all the time.”

There are other options, too.

N95 masks:

Throughout the pandemic, N95s have been considered among the best personal protective equipment, even for healthcare workers. Sims, mirroring the new CDC guidance, suggests wearing N95s if possible, especially in high-risk conditions.

Approved by the National Institute for Occupational Safety and Health, the dense, plastic polymer fibers of an N95 mask carry a static electricity that filters out 95 percent of airborne particles. The CDC maintains a list here of NIOSH-approved manufacturers and masks.

The mask should fit snugly. Most N95s for that reason have two elastic straps that loop around the back of the head, rather than the ears. If a mask listed as a N95 loops around the ears, it may be fake.

In health care settings, workers are “fit-tested” to make sure they have the most snug fit for their face shape and size.

“The problem with N95s is — if they’re not fit-tested — we’re not clear on how well they’re keeping out particles,” said Dr. Rebecca Schein, pediatric infectious disease specialist at Michigan State University. “The whole point of the N95 is that they have to be fitted to your face. That’s really true for any mask. If it’s drooping off your face, it’s too big.”

Aaron Collins, known and widely respected nationally as #masknerd, agreed

“The mask you don’t wear is one that doesn’t work,” he said in a YouTube video earlier this year advising parents on how to find the best mask for children returning to school.

Collins’ background is mechanical engineering and aerosol science, and he’s tested the filtration efficiency of hundreds of masks, maintaining an open, searchable document of his results.

For bearded men especially, like Sims, the N95 is the best mask, according to a study published in May in the peer-reviewed Journal of Exposure Science and Environmental Epidemiology. Facial hair “alters the fit” of masks, allowing gaps, but N95s work best — not only as the most protective mask from the get-go, but also the mask that lost the least “fitted filtration efficiency” for those with facial hair. (The CDC, which lists legitimate manufacturers, also lists some fakes in the second part of this list here.)

Large retailers most often work directly with reputable manufacturers. Among them is 3M — a large manufacturer of N95s — which advises consumers to purchase 3M products from its authorized dealers, and has set up a consumer web page and hotline to report bogus masks.

KN95 and KF94s:

The KN95 is manufactured to meet Chinese medical mask standards, and the CDC recommends that consumers use these, if not using N95s.

KF94 masks, designed to meet the mass market in Korea, generally filter 94 percent or more of particulate matter, mask experts say.

Both are far more comfortable than N95s and likely the best pick for the general public in most situations, both Collins and Sims said.

But consumers should be cautious of purchasing the products on large online marketplaces that don’t vet the validity of the seller, Collins said.

“I have nothing against Jeff Bezos (Amazon founder), and Amazon is a nice marketplace for some things,” Collins said. “The problem with the Amazon marketplace is that there is no control for counterfeits.”

Collins suggests purchasing online masks from websites such as www.projectn95.org and www.armbrustusa.com, which sell masks only from trusted, vetted sources.

Be wary of masks that are shipped loosely, appear dirty or mishandled, or arrive in packaging other than the manufacturer’s.

Additionally, the CDC also offers guidance and pictures to help the public spot bogus masks.

Procedure and cloth masks

Procedure masks are the ubiquitous, disposable masks designed for one-time use, while cloth masks were sewn for dangerously short-supplied health care workers in the early days of the pandemic and have since taken off in a fashion market of their own.

They offer less protection than the others — with cloth masks being the least protective of all. Still, “any mask is better than no mask,” CDC director Rochelle Walensky said last week.

Similar to the more recommended masks — N95s, KN95s and KF94s — cloth and procedure masks work best when the fit is snug over your nose, mouth and chin. Masks should have multiple layers of non-woven material and a nose wire, or consumers can layer a cloth mask over a procedure mask, the CDC suggests, for extra protection.

Consumers should use the “knot and tuck” method when using procedure masks for the best defense.

Advises the CDC: “If the mask has a good fit, you will feel warm air come through the front of the mask and may be able to see the mask material move in and out with each breath.”

“Basically, if you wear glasses and you put the mask on your face and you breathe out and your glasses fog up, you don’t have a good seal,” said Michigan State’s Schein.

On Thursday, President Biden announced plans to make free, “high-quality” masks available to the general public. A stockpile of 750 million N95 masks is reserved for health care workers, according to the White House.

It’s not clear what masks he referred to specifically, nor how Americans will receive them and when. Details are expected later this week.

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