Effectiveness of face masks for the population.

Background: Health authorities and organizations consider non-medical face masks as an additional passive means to prevent virus diffusion. Communication strategies disseminate information among the population that such masks are essential for mitigating virus diffusion. However, scientific studies are not conclusive in showing the undisputed filtration efficiency of fabric/cloth facial masks (both commercial and homemade). Objectives: This study examines scientific data about the effectiveness of face masks before and during the COVID-19 emergency. Present trends in the making of commercial and homemade fabric/cloth face masks are also examined. Methods: Statistical data of published studies are analyzed and compared. Main considerations and sugge-stions are also extracted and discussed. Current approaches are examined for assessing the characteristics and effectiveness of fabric/cloth commercial and homemade face masks intended for the population. Results: Conflicting data exist as to whether non-medical masks have a protective effect from the spread of respiratory viruses. Both medical masks (MDs) and respiratory personal protection equipment (PPE) show a given effectiveness value. Conclusion: Concerning commercial and homemade fabric/cloth masks, giving general indications on the choice of materials and their assemblage is difficult as it is not possible to assess the effectiveness of the filter media with respect to the kind of multiphase fluid that may be emitted upon breathing, sneezing, or coughing under different environmental conditions. This is particularly important because airflow rate, temperature, humidity, and duration of use will affect the performance of filter media. Moreover, while a mask may have excellent filter media, droplets may leak into the face-piece unless there is an adequate facial seal. In the presence of leaks, any type of mask may actually offer less protection independently of its nominal filtering effìciency.

A complete atrioventricular block case during SARS COV2pneumonia. Case Report

Description of the case: A 83-year-old man has been hospitalized for fever, cough and dyspnea in our UOC pneumology Covid fornasopharyngeal swab positive for SARS COV2. In anamnesis itpresented hypertension, COPD and atherosclerotic vasculopathy.At the entrance it has dyspnoea, BP 130/80 mmHg, CF 72 bpm,no heart failure symptoms, Ps 02 89% in ambient air. Pulmonaryauscultation demonstrated the presence of ronchi spreads tochest with hypomobile bases. At ECG sinus rhythm was 65 bpmwith repolarization anomalies QTc470 ms. Echocardiography wascompatible for hypertensive heart disease. Bilateral thickeningswith an emery glass appearance in the bilateral basal middle fieldat the chest CT scan. Laboratory showed the signs of inflammation.He begins antibiotic and antiviral therapy with lopinavir, LMWH,dexametazone and O2 therapy with integral mask with fi02 50%peep 10 mmHg. The respiratory symptoms have improved but itshowed up steep edema, asthenia, bradycardia with difficultyspeaking. Ecg presents complete atrioventricular block with junctional escapement at 35 bpm. Bilateral thickenings with an emeryglass appearance in the bilateral basal middle field at the chestCT scan. Laboratory showed the signs of inflammation. He beginsantibiotic and antiviral therapy with lopinavir, LMWH, dexametasone and O2 therapy with integral mask with fi02 50% peep 10mmHg. The respiratory symptoms have improved but it showed upsteep edema, asthenia, bradycardia with difficulty speaking. ECGpresents complete atrioventricular block with junctional escapement at 35 bpm. Ps O2 94% in O2 at 4 l / m. The patient waspromptly taken to the electrophysiology room for the definitive single-chamber pacemaker implant. Clinical and hemodynamic conditions have improved as well as lung and ventilator conditions.Conclusions: In our experience we have observed the presenceof numerous cases of heart rhythm disturbances both in the bradycardic and tachycardic sense not only iatrogenic but also suggestive of a direct action of the SARS-CoV2 virus on the cardiacconduction system.

Face masks. Technical, technological and functional characteristics and hygienic-sanitary aspects related to the use of filtering mask in the community.

INTRODUCTION: The health emergency caused by the spread of SARS-COV-2 virus has required the adoption of passive measures against contagion, such as social distancing. The use of filtering masks, of the different types available on the market, such as surgical and facial filtering masks (FFP1, FFP2 and FFP3), is also recommended. OBJECTIVES: The aim of this paper, within the Italian and European regulatory reference framework, is to suggest a rational application of existing methodologies that enable to know and assess the features and/or make a face mask intended to be used by the community. In addition to this, the study aims to provide a correct regulatory framework and useful information for a correct use and disposal of face masks. Another purpose is the assessment of the hygienic, sanitary and regulatory aspects related to the use and disposal of face masks. METHODS: The analysis of filtering masks is based on the review of scientific literature, the state of art of technology and the filtering means/materials available. Reference is made to filtering mechanisms and devices, the testing methods, the technical, manufacturing and performance features, and to the Italian and European regulatory reference framework. Reference is also made to the hygienic, sanitary and regulatory aspects related to the use and disposal of face masks. RESULTS: Surgical masks or, alternatively, filtering masks with a filtration efficiency between 90% and 95% for 3-µm particles, are the most practicable choice with minor contraindications. The reusable type of mask is conceptually superior compared to single-use masks, but cleaning procedures to be followed are quite complex and not always described in a clear way. CONCLUSIONS: The definition of rigorous and repeatable tests on mask filtration capacity, breathability, wearability, duration of use, regeneration, as well as safe disposal methods, are the main way to provide users with correct selection and use criteria. The results must be disclosed and disseminated quickly.