NOTE TO READERS: The CDC is now recommending the use of N95 face coverings, another shift in guidelines in the new pandemic landscape. In light of that, here’s a perspective on masks, mask use, the debate over masking and the frustration it can all engender. Share your own thoughts about these subjects by writing to news@chathamnr.com, and we’ll publish selected responses in next week’s edition.
SILER CITY — I set off on a recent vacation armed to the teeth with masks.
Our travels involved airports, planes, confined spaces and locales where indoor and outdoor masking was required, so I carried with me a Ziploc bag full of face coverings — nine in all, sourced from a variety of places, and enough to make the Lone Ranger green with envy.
They included a pair (one solid black, one white) of monogrammed surgical-type masks I pocketed at the recent wedding of a second cousin, featuring the happy couple’s initials. My “Chatham News + Record” mask custom-made by Pittsboro’s own geekchicfashion. A snazzy-looking BOLD Real Estate mask I scored from my business partner, Chris Ehrenfeld. A mask I’d ordered online a year ago after a newspaper publisher friend posted a selfie wearing the same, along with a testimonial that he’d finally found a comfortable face covering that wouldn’t fog his glasses. (My glasses still fogged, but the mask is comfy, at least.) And an expensive “best travel mask” I ordered after seeing happy air travelers sporting them on Instagram, swearing it was the most comfortable thing they’d ever strapped to their heads.
I’m a sucker for a good marketing ploy.
Which made me all the more disappointed with the masks I didn’t have.
A couple of weeks prior to our trip, I took it upon myself to go for extra safety by ordering a box of 30 KN95 masks. The Centers for Disease Control and Prevention — the CDC — had, after all, just put out an advisory to avoid traveling on a cruise ship, regardless of vaccination status. The agency cited an increased risk of severe illness on ships and announced that nearly 100 ships were “under observation” because of increased COVID cases.
Undaunted, and determined to go on our cruise, I ventured onto Amazon.com to score some KN95s, ensuring they’d get delivered in plenty of time for our trip. Alas, immediately after my order, the estimated arrival time of the KN95s mysteriously changed from four days prior to our departure to a week after we’d be getting home.
And by the time they arrived, after our vacation was over (no COVID issues whatsoever, by the way), the CDC had put out a fresh warning: be aware of the surfeit amount of counterfeit KN95s.
Sure enough, the box of KN95s I’d plopped down $35 on were fakes.
Oh, and one more thing from the CDC while I was away: what you really should be doing is wearing an N95 mask.
Which I didn’t have.
A 2020 survey done by the Chatham County Public Health Department and posted on its website said 90.7% of Chatham residents polled mask up. My own observation, a year and a half and two major variants later, is that the actual number is far, far less.
My favorite grocery store has a sign at the entrance politely requesting all customers to wear face coverings, regardless of vaccination status. On a good day, maybe 60% of customers comply.
It also depends on where you are. You’re more likely to see masking in Pittsboro than Siler City, for example. I recall walking into one Siler City eatery back during the state’s indoor masking mandate. A sign on the business’ door said face coverings were required for entry, yet not one of the three customers inside and none the four employees there — including the two who worked on my to-go order — were masked.
Now in 2022, two years into a politicized pandemic, masking (and vaccinations, which I’ll refrain from talking about here) remain third rail topics. Highly charged disagreements, of course, are de rigueur. At the Chatham County Board of Education’s retreat on Jan. 11, for example, an extended discussion — comments from anti-masking parents and debate among board members — lasted 45 minutes.
One frustrated parent said to board members, “Facts don’t matter.”
“We know masks don’t work,” she said, then accused board members of being under hypnosis and “drunk on power.”
Board member David Hamm, who alone has advocated for optional masking among that group, made the tongue-in-cheek suggestion that if we’re going to continue to require students to be masked, we should also buy lots of bubble wrap to keep them safe — in case they were to fall. (The board voted at the retreat to keep the system’s mask requirement in place for another month; a follow-up motion Hamm made to make masking optional for athletes failed to receive a second and wasn’t voted upon.)
So we talk a lot about masks, but what kind of masks — a topic Hamm touched on — is suddenly very relevant.
N95s are one type of specialized filtering masks which typically provide a tighter fit to your face than cloth masks and are made with a special material designed to block 95% of harmful particles. The fibers that qualify N95s as such are pressed closer together than in cloth masks and contain an electrostatic charge that attracts molecules to stick to the mask — rather than passing through.
The CDC, again, in its evolving guidance for mask-wearing, previously said N95 masks should be reserved for health care workers because of supply shortages. But the new guidance includes the recommendation of N95s for everyone, with an added emphasis that a good-fitting mask that is worn properly, and consistently, is most critical.
The agency didn’t formally recommend N95s over cloth masks. “Any mask is better than no mask,” CDC spokeswoman Kristen Nordlund said. But it did emphasize that properly fitted N95 and KN95 masks offer the most protection against COVID-19 — better than cloth — particularly given the transmissibility of the Omicron variant.
So how do you get one? An authentic one?
The Biden administration announced a plan to make 400 million N95 masks available for free to U.S. residents. The federal government has a stash of more than 750 million N95 masks as a part of the Strategic National Stockpile, and the White House plans to make the masks available for pickup at pharmacies and community health centers across the country. The masks began arriving at pharmacies and grocers around the country on Monday.
In North Carolina, the state’s Dept. of Health and Human Services already sent N95 masks to every local public health department, according to Zachary Horner, a spokesman for the Chatham County Public Health Department (and my eldest son, by the way.)
“Last week, we received 7,300 N95s and promptly distributed them to prioritized settings in the county, including the Chatham County Council on Aging, The Hispanic Liaison, Brookwood Farms and Chatham County Emergency Management to distribute to fire stations across the county,” he said.
Most of that distribution happened within a day or two.
“We’re so grateful for this distribution, as the CDC has stated that NIOSH (National Institute of Occupational Safety and Health)-approved respirators like the N95 ‘provide the highest level of protection from particles, including the virus that causes COVID-19,’” Horner said, quoting the CDC directive. “However, other masks and respirators, like cloth face masks, still provide good protection.”
Confused? Don’t be.
If the changing recommendations from the CDC seem confusing to you, you’re not alone. But understand: N95s are hard to find, they’re difficult to wear for long periods of time, and because they’re so often counterfeited, your elusive search for the best protection possible may end up with you getting bamboozled.
But you can still safeguard yourself. You can, and you should.
“The most important thing is to wear a well-fitting mask consistently and correctly,” said Mike Zelek, the director of Chatham’s Public Health Department. “Throughout the pandemic, including during the recent Omicron surge, we have mostly seen COVID spread in settings with prolonged close contact where masks are not worn consistently, like gatherings and household contact.”
The high transmissibility rate of Omicron should prompt Chatham residents to “up your mask game,” he said.
“An N95 or KN95 can give you as the wearer an additional level of protection,” Zelek said. “Prioritize the masks for situations where you are spending more time indoors close to others outside of your household, especially if masks are not being worn by those around you. Even with these masks, it is still most important that it is well-fitting and worn consistently and correctly.”
Cloth masks are designed to be washed and reused — which typically isn’t the case for N95 masks. (Honestly, when’s the last time you washed your cloth mask? Have you ever washed your cloth masks?)
But still, Zelek says, there are some things you can do to make masking more effective.
“Rotating masks is an easy option,” he said, “storing them in a breathable paper bag. It is best to limit to five uses per mask if possible. If your mask becomes dirty or poorly fitting, discard it. And going back to the settings where they provide most benefit, if you have a limited supply, prioritize them for higher risk activities, for example, when indoors in close proximity to others for longer periods of time, especially if others aren’t masked.”
I also posed the mask question to Eric Wolak, the chief operating officer and chief nursing officer at Chatham Hospital. He gave it to Johnsie Hubble, the infection preventionist at Chatham Hospital, who also emphasized proper wearing.
“The fit of the mask is important, and they go over that with tips to improve the fit or add layers of protection,” she said, referring to guidance on the CDC’s coronavirus site. “N95 masks are the best option and can be found for purchase; but do not get one with a vent. You need one without a vent. They fit very snug against the face and are secured behind the head. Therefore some will have problems wearing them for long periods due to discomfort.”
And this is important: Cloth masks alone are not that protective against Omicron, Hubble said, but can work for many people when placed over a surgical mask to improve fit and add layers of protection.
As for KN95 masks, Hubble said many on the market are “not up to meeting U.S. mask standards of the National Institute of Occupational Safety and Health (NIOSH).”
Also: KF94 masks from Korea are supposed to be the equivalent of an N95; see the CDC web page for more information.
“But if you can find a KN95 that is not counterfeit, then those are a good option,” she said.
I should have checked with Johnsie earlier. It was from the CDC site that I learned my box of masks labeled KN95s were fake.
I tried to post a negative review on Amazon, citing stories from the New York Times and guidance from the CDC, but my post was rejected.
“It appears your content did not comply with our guidelines,” Amazon told me in an email. “Your review should focus on specific features of the product and your experience with it … Please do not include URLs external to Amazon or personally identifiable content in your review.”
The other purchasers whose reviews were published — 260 of them — gave the masks an average rating of 4.5 out of 5 stars. Most probably don’t peruse the CDC site or bombard Zelek, Wolak and Hubble with emails like I do.
So here ‘tis: “HALIDOD masks are a Prime example of a counterfeit product. Don’t buy them.” (By the way, those masks are now “unavailable” on Amazon, so … there’s that.)
As someone who masks when he’s supposed to, I’m ready for the pandemic to end. It’s brought out the best in many of our health care professionals and the worst in too many others. It’s not surprising that, two years into this — with health care workers overwhelmingly overwhelmed — there are some who suggest we deny medical care to unvaccinated adults.
I said I wasn’t going to talk about vaccinations, and I’m not; this is an argument that has gotten a lot of airtime. Ed Yong, writing in The Atlantic, spelled it out this way:
Every adult in the U.S. has been eligible for vaccines since April. At this point, the unvaccinated have made their choice. That choice is hurting everyone else, by perpetuating the pandemic and, now, by crushing the health-care system. Most of the people hospitalized with COVID are unvaccinated. It’s unethical that health-care workers should sacrifice for people who won’t take care of themselves. And it’s especially unethical that even vaccinated people, who did everything right, might be unable to get care for heart attacks or strokes because emergency rooms are choked with unvaccinated COVID patients.
It’s a theoretical argument, Yong writes, but it’s out there. When he asked medical professionals about not treating the unvaxxed, he said: “ … all of them said that it was an awful idea — unethical, impractical, and founded on a shallow understanding of why some people remain unvaccinated.”
Then there’s the death-shaming — websites and social media accounts dedicated to celebrating the deaths of anti-vaxxers and COVID deniers who died from COVID.
Like I said, we’ve seen some people at their worst. But two years on, most of us have seen death, too. Some of us pretty close up.
I get it. “Get fully vaccinated and live a somewhat normal life.” Then Omicron.
Writing in The Atlantic, Melinda Wenner Moyer said, “It feels like we don’t have anything momentous to look forward to. There is no much-anticipated cure just over the horizon anymore. There is merely more of the same.”
Which can make masking up a deary thing.
On Monday, I ran into Alice Pearson, a medical assistant at Pinehurst Surgical Clinic. She was wearing an honest-to-goodness authentic N95 mask, and wearing it properly. I was jealous.
I asked her what she thought about masks, and whether she was tired of wearing them all the time.
“I hate ‘em,” she said. “But I’d rather be behind a mask than behind a ventilator.”
She’s seen things in the last two years I hope I never have to. So I’m with her.
Bill Horner III can be reached at bhorner3@chathamnr.com or @billthethird.