Cloth masks have become the choice of some people amid the scarcity of surgical masks to protect themselves from the new type of Coronavirus COVID-19. The doctor and Head of the ENT Department of Health Sciences, Faculty of Medicine, Public Health, and Nursing (FKKMK) UGM, Dr. dr. Bambang Udji Djoko Rianto, Sp.THT (K)., M. Kes., said the use of cloth masks was less effective in preventing COVID-19 transmission and could only be used as a last alternative.
"Fabric masks cannot protect the entry of particles. When using a cloth mask, 97 percent particle can penetrate the mask because the protection is only 3 percent,” Bambang explained on Tuesday (14/4).
He mentioned the mechanism of transmission of the virus, among others, through a sprinkling of saliva (droplet) and airborne (small particles carried by air). Cloth masks do not have protection like a surgical mask consisting of 3 layers. The three layers of the surgical mask are the waterproof outer layer to protect the droplet, the middle layer to filter germs, and the inner layer to absorb the liquid that comes out of the user's mouth. This surgical mask protection level is around 56 percent for nanometer-sized droplet particles.
"Those three layers do not exist in the cloth mask, and this is dangerous. Because, once the sticky virus can penetrate between the pores of the fabric,” said ENT doctor Dr. RSUP Sardjito.
Meanwhile, the N95 mask does have the best effectiveness level of transmission prevention because it has a denser density compared to surgical masks and cloth masks. Moreover, this type of mask has excellent protection for droplets and aerosols—allied health who have direct contact with patients usually used to wear this type of mask.
"The effectiveness of prevention of N95 masks is the best, but it is not recommended for daily use for healthy people because it can cause difficulty breathing," he explained.
Bambang said that there was research conducted by comparing the effectiveness of using surgical masks with cloth masks. The study has been published in the journal BMJ Open (2015) entitled A Cluster Randomised Trial of Cloth Masks Compared with Medical Masks in Healthcare Workers. In a study conducted in Hanoi, Vietnam, in 1,607 hospitals, it was found that there was a very significant difference between the use of surgical masks and cloth masks in preventing respiratory infections and viral infections.
"The results are extraordinary. It turns out people who wear cloth masks are likely to suffer from respiratory infections and viral infections 13 times greater than those who wear surgical masks. This phenomenon is dangerous,” he explained
The new type of Coronavirus has a small exchange size of 0.125 micrometers or 125 nanometers. Meanwhile, the fabric does not have sufficient density to filter tiny particles. Even so, this cloth mask can be the last choice if the availability of surgical masks is tough to obtain.
For example, wanting to use a fabric mask for self-protection, Bambang advised the public to coat a 2-layer fabric mask with tissue in the middle. This suggestion aims to increase protection against possible entry of particles into the mask.
"Indeed, until now, there has been no research that examines the effectiveness of using this 3-layer fabric mask. However, the logic is denser so it can better protect from virus infections,” Bambang explained.
Bambang reiterated that cloth masks could be used as a last alternative to protect themselves from the threat of COVID-19 transmission. However, people must be aware of other factors must also be followed to prevent transmission such as physical distancing, diligently washing hands with soap, and maintaining cleanliness.
"Adhere to physical distancing to help cut COVID-19 transmission," he concluded.
Translator: Natasa A