Outward and inward protections of different mask designs for different respiratory activities (preprint)

We evaluate the outward and inward protections of different mask types (N95, surgical and two cloth mask designs) taking into account the imperfect fit on the wearer. To this end, we built a manikin to simulate exhaling, coughing and inhaling of aerosol droplets 0.3–5.0 µ m in diameters. The outward and inward protections depend on many factors, including the droplet size, the mask fit and the presence of a filter layer. Here, we show that cloth and surgical masks with a non-woven filter layer can achieve a combined outward and inward protections between 50% and 90%. Removing the filter layer greatly reduces the protection efficiency to below 20% for the smallest droplet size. While a well-fitted N95 masks offer protection efficiency close to 100%, a poorly fitted N95 mask with gaps offers less protection than a well-fitted surgical/cloth mask. We also found that double masking—the wearing of cloth mask on top of a surgical mask—is only effective at reducing outward droplet emissions when coughing, while offering no additional protection when exhaling/inhaling as compared to a single cloth/surgical mask. The results of our work can inform the implementation of mask mandates to minimize airborne transmissions of coronavirus disease of 2019 (COVID-19). Practical implications A single cloth/surgical mask with non-woven filter layer offers significant protection against airborne transmissions. Filtering facepiece masks such as N95 respirators are unlikely to achieve the advertised high protection for the general public due to poor mask fit. Double-masking offers little to no additional protection over a single cloth/surgical mask.

Effective design of barrier enclosure to contain aerosol emissions from COVID-19 patients (preprint)

Facing shortages of personal protective equipment, some clinicians have advocated the use of barrier enclosures (typically mounted over the head, with and without suction) to contain aerosol emissions from coronavirus disease 2019 (COVID-19) patients. There is however little evidence for its usefulness. To test the effectiveness of such a device, we built a manikin that can expire micron-sized aerosols at flow rates close to physiological conditions. We then placed the manikin inside the enclosure and used a laser sheet to visualize the aerosol leaking out. We show that with sufficient suction, it is possible to effectively contain aerosol from the manikin even at high flow rates (up to 60 L min-1) of oxygen, reducing aerosol exposure outside the enclosure by 99%. In contrast, a passive barrier without suction only reduces aerosol exposure by 60%.