CDC Says Cloth Masks Are Better Than Nothing, Encourages Nurses to Use Bandanas, Scarves

Chris Menahan
Mar. 18, 2020

Faced with a massive shortage of N95 face masks, experts are saying that everybody should be wearing masks even if they have to make them themselves out of cloth.

From Roll Call:
As the national shortage of face masks becomes severe, the Centers for Disease Control and Prevention says nurses can use bandanas and scarves as makeshift masks when caring for COVID-19 patients -- although it's unclear whether they would protect medical workers. 

The CDC says that option should be used "as a last resort" and only when the hospital nearly depletes its supply and experiences a crush of COVID-19 patients, reaching "crisis capacity." The CDC acknowledges that its recommendations are out of step with standards of care in the United States.

Nurses and other health care providers can "use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19," the CDC website now reads. The agency says in the next sentence that the homemade masks' capability to protect health care providers against the coronavirus-caused disease "is unknown."
"Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face," the CDC website says.

It's worth noting this about face came one day after the New York Times ran an article from Dr. Zeynep Tufekci titled, "Why Telling People They Don't Need Masks Backfired."

This is the bad advice she was talking about:

Dr. Tufekci cited a 2013 study showing even homemade masks are better than nothing as they keep a significant amount of fluid from leaving people's mouths when they cough or sneeze.

The N95 mask shortage is not going to end any time soon as they're very complex to make, as NPR reports:
Currently, of the 200 million masks China makes a day, only 600,000 are N95 standard masks, used by medical personnel, according to the National Development and Reform Commission, a state planning body. Provincial regulators have granted dozens of new licenses to open additional factories capable of producing top-grade masks, including those that meet the standards for use by health-care professionals.

But this ambitious effort has run into a bottleneck.

Both the masks made for medical personnel and for consumer purchase require a once-obscure material called melt-blown fabric. It's an extremely fine mesh of synthetic polymer fibers that forms the critical inner filtration layer of a mask, allowing the wearer to breath while reducing the inflow of possible infectious particles.

"We're talking about fibers where one filament has a diameter of less than one micron, so we are in the nano area," said Markus Müller, the sales director at German company Reicofil, a major provider of melt-blown machine lines.

And there's now a global shortage of melt-blown fabric due to the increased demand for masks — and the difficulty in producing this material.

Costing upward of 3.8 million euros ($4.23 million) apiece, the machine that creates this fabric melts down plastic material and blows it out in strands, like cotton candy, into flat sheets of melt-blown fabric for face masks and other filtration products. A similar line of machines can create a related kind of fabric, called spun-bond fabric, also used in face masks and in medical protection suits worn by health-care workers.

The machines are not easy to make because of the exacting precision required, says Müller: "You need to stretch these fibers by hot air, and [the air] needs to be in perfect condition over the width of the machine. The biggest dilemma is that many of the machines are not producing consistent quality."

Reicofil's Müller says he gets more than four dozen requests a day, mainly from China, to buy melt-blown fabric and production lines but has to turn nearly all of them away; making a single machine line takes at least five to six months.
Mask manufacturers are being absolutely swamped.

From Wired, "The 'Surreal' Frenzy Inside the US' Biggest Mask Maker":
Mike Bowen can't remember exactly when the calls started. As the co-owner and executive vice president of Texas mask manufacturer Prestige Ameritech, he says the last few months have been a blur. His office phone and cell now ring practically nonstop, and Bowen says he often ends the day with more than 150 missed calls and hundreds of emails. (During one 40-minute interview, the company's office line rang so often it was difficult to tell when a new call began.)

Bowen's voicemail inbox is littered with messages from hospitals and medical distributors in dire need of surgical masks, N95 respirators, and other forms of essential protective gear his company makes. There are also emotional pleas from elderly people and fearful parents of immunocompromised children desperate for a way to limit their potential exposure to the novel coronavirus, as the pandemic sweeps around the globe. And then there's the stream of callers looking to capitalize on the global shortage of personal protection equipment by buying masks in bulk to sell at a markup on ecommerce platforms like Amazon and eBay, a practice that the companies have recently curbed due to a wave of price-gouging.

In an attempt to keep up with demand, Prestige Ameritech's management team is working 80-hour weeks, bringing previously idle machines online, and hiring and training dozens of new employees to augment its staff of around 100. Back in what Bowen calls the "peacetime," before the pandemic, Prestige Ameritech made roughly 250,000 masks a day. Now the company has ramped production up to 1 million masks a day.

But even that isn't enough. "Since February 1, we've had to turn down orders for 100 million masks or more a day on average," Bowen says. "Sometimes, we turn down 200 million or 300 million [masks] a day. It's kind of surreal."

US mask manufacturers say they are experiencing unprecedented demand. With the pandemic and trade restrictions pressuring already-overwhelmed global supply chains, companies are struggling to keep up. Like much of the mask manufacturing industry, industrial giant 3M has been ramping up production since January—including expanding the output of its US based factories, hosting job fairs, and hiring employees on the spot. Yet some US hospitals are still unable to obtain new shipments of surgical masks and N95 respirators.

"There's a really, really high demand for respirators and really all other products being used in response to the coronavirus to help treat and protect people," Jennifer Ehrlich, communications manager for 3M told WIRED. "It's more demand than any one company can supply, and we expect it to remain high for the foreseeable future."
We're going to have to make due with what we've got.

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