Covid19 and a simple cloth mask
Cloth masks as one of the possible solutions for stopping or slowing down the transmission of Covid19 sounds pretty logical. Looking at the magnitude of the problem, it comes across as a solution too simple to be true.
It is a well-known fact that viruses can ‘survive’ outside a host body. The longevity depends on the type of virus and the environment in which it will have to exist. A viable virus can float as aerosols or cling on to various surfaces.
Regarding surfaces, it is also a well-known fact that most viruses like inert non-porous surfaces. This includes materials like steel, aluminum, glass, plastic, etc. No wonder, marine life experts & activists have been warning about littering the sea with floating plastics and other similar material. Such plastispheres act as a substrate for various micro-organisms and hence could trigger a marine life epidemic.
Covid19 is caused by a Novel Human Coronavirus, scientifically known as SARS-Cov2. Like its family members, it too seems to prefer inert non-porous surfaces. Sadly there surfaces are the ones that create the glitz and glamour of the modern world. Be it our airports, metro stations, office complexes, shopping malls, hotels and restaurants, cruise ships, even modern hospitals & clinics; literally everything built for elite or urban consumption is built using these materials. The more modern a society, farther it is from the reality of sun, wind and dust.
The research so far shows that Novel Human Coronavirus has significantly high longevity outside the host body. The New England Journal of Science pegs the outer limit at 72 hours on steel surfaces. The Journal of Hospital Infection has shared information about Human Coronavirus, which is a predecessor of the current Novel Human Coronavirus. As per the study, Human Coronavirus can be viable outside host body for up to 216 hours, i.e. 9 days. Experts believe that with favorable temperature and humidity, coupled with lack of natural elements like sunlight, rain & wind, viruses can remain viable for some more time. Many suggest that this figure could be 2 days or more.
In such a scenario, it is highly possible that airports, malls, hotels, office complexes, planes, etc. could be acting as serving bowls of Coronavirus.
Can a cloth mask save the world?
My view is that everyone wearing a mask while venturing out of their homes could be a possible solution for controlling Covid19. And when I say mask, I am not talking about N95’s and surgical masks. I am talking about simple two layered cloth masks. Many people can make such masks themselves. If such masks are not available then tying a cloth napkin, handkerchief or scarf to secure one’s nose and mouth would also suffice. The basic idea is to contain the ‘leakage’ rather than inhale the ‘leakage’.
Let me explain!
It is believed that a significant proportion of people infected with Covid19 would show mild symptoms. Many may not even realize that they are infected. At the current level of fear and anxiety across the globe, many will choose to live in denial. Such a patient may self-heal in due course of time but that does not mean that he or she would not transmit the disease. And then we have asymptomatic patients. These are people who are carrying the virus but have no symptoms. By the time these patients end up developing symptoms, they would have already infected many others. Some studies suggest that asymptomatic patients could be causing as much as 12% of total infections.
Now imagine an infected person talking, coughing or sneezing. The proportion of particles coming out of his/her nose or mouth and landing on someone’s face or body will be significantly low. The current social distancing measures would reduce this proportion further. But these particles are not going to vanish in thin air. Gravity is not under lock down hence these particles would end up landing somewhere. And if the surface on which they land is a happy surface for them, they would hang around, thus keeping the trail of infections alive!
But in a scenario where everyone is wearing a mask, the proportion of particles landing on various surfaces would reduce significantly thus reducing the chances of transmission through surfaces. This mode of transmission is currently regarded as a major issue which it why various governments as well as the WHO are insisting that people wash their hands regularly and use hand sanitizers. Apart from reducing the overall contaminated surface area, this would also reduce the viral load/titer (quantity of virus per unit area or volume). Lower the viral load, lower would be the chances of infection spread.
Studies so far reveal that Novel Human Coronavirus can also spread through aerosols. It is believed that such aerosols can survive in air for up to three hours. Masks will not only reduce the volume of aerosol contamination but also reduce its viral load.
To ensure that I am not hallucinating and spreading false hope, I cross checked the viability of this solution and found that masks seem to have played a significant role in controlling the Spanish Flu epidemic of 1918.
Why cloth masks?
Masks like N95, etc. are designed for high efficiency. They are designed for professionals working in high risk areas. For ordinary people it could be an over design. Plus its fit could be a problem because of which people will keep adjusting them – which the doctors do not want to happen as it may increase the risk of infection. On the other hand, one can make or buy well-fitting cloth masks. Tying the mask around the neck or head instead of using elastic ropes around the ear would make it easy to use.
Another reason in favor of cloth masks is pure economics. It would not be possible to fabricate and distribute masks like N95 to everyone. Moreover, they are not washable. We may end up creating a huge pile of medical waste, which will have to be disposed properly. Cloth masks, on the other hand, can be washed with soap and reused.
I got a feedback from one doctor that wearing a mask in hot climate zones is a pretty repulsive idea. What he did not realize is that people living in hot areas anyways cover their mouth and nose using cloth napkins, scarfs, etc. during the summer season.
Moreover, everyone roaming around with a N95 sort of mask would look pretty weird. But masks of different shapes and colours would positively alter the landscape. If one can tie a cloth around one’s neck and call it a ‘tie’, I do not understand why wearing a mask is such a big issue, especially when it is temporary and for everyone’s welfare.
Politics of masks
The obvious question is – if this is a possible solution then why did the authorities dissuade people from wearing masks and said that it could be a counterproductive action. I think there is a reason behind that move.
When the fear of Covid19 gripped the world, people scrambled for masks. Everyone wanted the highly reliable top of the line N95 masks. As they are consumables, people started hoarding them. Suddenly there was a shortage. Governments were not able to ensure smooth supply of these masks to their health care workers. I think that this could be a reason why opinion makers and newsrooms started claiming that a healthy person does not need a mask. In order to fix the supply lines, the obvious got skipped.
I do not think that this is a complex issue to understand. Just visualize an asymptomatic covid19 patient with a mask and without a mask. What do you think will work?
A possible quick fix
Let us consider this. For 15 days, we lock down every infrastructure which has virus friendly surfaces, globally. This means all the airports, offices shopping malls, etc. Simultaneously, we also park all the planes, buses, trains and taxis. The logic of 15 days is simple. If we consider the 9 day figure provided by The Journal of Hospital Infection and add three more days to it (for virus friendly environments), it would total up to 12 days. For safety reasons, let us add 3 more days, taking the figure to a total of 15 days. In these 15 days the viral load of any surface should ideally become negligible, even without sanitization. Sanitization of places with higher footfall could be undertaken as a precautionary measure.
Now, instead of locking down the masses, we put everyone behind a mask and apply mild lock down restrictions for the purpose of social distancing. However, during this period there would some vehicles and infrastructure that would be put to use for ensuring public services and maintaining supply chains. Such infrastructures and vehicles can be regularly sanitized for this period.
My view is that these actions can significantly bring down the global transmission rate of Covid19. If we were to club these action with large scale testing to isolate anyone who has any symptoms, we should be able to effectively segregates the haves and have-nots within 20 days time frame. Even if we are not able to ramp us the testing, masks should help us control the rate of infections and taper the graph to a near zero level in relatively short time.
Doesn’t it sound logical?
To me, the solution seems pretty logical though it comes across as too simple to be true. But then, it is the simple ideas that have always changed the world.
I know that it is highly unlikely that the whole world will come to an agreement on simultaneous action and lock down. So, it is the citizens who will have to build the pressure. In order to save their respective economies and political standpoints, various governments have already created enough mess. They have significantly amplified the net economic impact through actions taken to supposedly mitigate their sole risks.
Reports from China are already showing that even though they have managed to curtail local transmissions, new imported cases are coming in as they open up their skies. Such cycles will continue unless the world can act as one.
And if no one agrees, then countries like India can go ahead with these measures, all alone. Not opening the borders till the scourge is globally controlled. I think that if this works well for any country, others will follow suit. In case of India, we have an added advantage of demographics. Most economies of the world cannot ignore a market.
And the masks?
Well, till the time Novel Human Coronavirus ceases to exist or a cure is found, it could be our ‘face tie’. Designers can pitch in to convert them into style statements. Who knows, people may keep wearing the masks even when Covid19 is long gone.