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Writer's pictureAlan Frischer, MD, MPH

Masks and Gloves

Is it just me, or does it seem as if we are living in a terrible late night science fiction movie? Today I am writing about the importance of masks and gloves. In our everyday life! This morning I went out on a long hike in our beautiful Santa Monica Mountains with my wife…keeping our distance, and wearing a mask. This is now allowed, but is it safe? Just how do we stay safe during a global pandemic?

Why wear a mask? Two great reasons: it benefits ourselves, and it benefits those around us. A family member, friend, or stranger may have the COVID-19 virus, display no symptoms at all, and continue to walk, shop, or work alongside us. The virus is living in their nose and mouth and can be projected into their immediate environment. And, if you happen to be the one who has the virus, with or without symptoms, you may be inadvertently be sharing your virus-containing droplets with others.

It is important to remember that our becoming ill requires that we receive a large enough dose of the virus. The closer we are physically to the carrier, the larger the dose. The sicker the carrier is, the greater the dose. That is why distance, in addition to wearing a mask, is critical. We keep hearing about six feet. There’s nothing magical about that distance; seven is better, and five not as good. Outdoors is safer, because the virus is diluted by a higher volume of air, and by air current. Enclosed spaces like restaurants, homes or yoga studios lead to a higher density of any virus that might be present.

Even an imperfect mask will block some or most of the virus-containing droplets. Most masks will filter out large droplets, even if they imperfectly filter smaller particles. Some masks are more effective than others. A properly fitted N95 mask, while most effective, is still in short supply even for medical personnel on the front lines. A surgical mask is loose fitting and disposable. They are not to be shared, do not act as a complete barrier, and were never intended to be used more than once. The best choice? A mask made of high thread count cotton, with another layer of polyester, which has a snug fit. It can be washed and reused.

Note that the virus resides in the both the nose and the mouth. A mask must cover both! How the mask is worn is critical. Gaps along the mask edge can degrade its performance by as much as 50%. While getting the virus through the eyes is possible, it is far less likely to be the route of entry for most of us. (Health care professionals and others in the line of duty are wearing eye shields.)

What about gloves? Even though the major route of transmission appears to be through airborne droplets, the current wisdom is that this virus can live on surfaces for up to three days. We touch a lot of surfaces wherever we go - doorknobs, elevator buttons, streetlight buttons, counters, grocery packaging, toilet handles, sink handles, etc. If we touch any of these and then touch our face, it is possible to transfer any virus present to our eyes, nose or mouth. We might then touch someone or something and spread the virus even further. What if we were wearing gloves? They become contaminated, instead of our hands. Let me restate that. Gloves are not automatically sterile. They can become contaminated, just like our hands. How many times have you seen someone wearing gloves touch their face or clothing? Those gloves are no longer clean.

A benefit of gloves is that they do remind us that we are attempting to stay sterile, and we tend to be less likely to touch our face or anything else. Gloves can be easily thrown away. If you intend to be at, perhaps, a store where virus might be living on surfaces, feel free to wear gloves – any type of rubber gloves – but be aware that they are no longer sterile the moment they touch anything.

Let’s continue to do our best to NOT get infected. COVID-19 is unpredictable, and has hospitalized and killed both young and old. Testing is not reliable, and we still don’t understand enough about antibodies and future immunity to count on that. For now, I urge you to use a mask, wear gloves when appropriate, avoid being with others in small spaces without good circulation, and maintain that six-foot distancing. I wish for you the very best of health.

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