With the recent onset of the Delta variant rendering havoc on an already strained economy and weary population post- the rabid COVID-19 surge, there is much debate on effective policies that negate the harmful outcomes of viral acquisition. The B.1.617.2 Delta variant originated in India and is among the most easily transmissible form of the novel SAR-CoV-2 pathogen, apart from the Alpha-Britain isolated, Beta-South Africa isolated, and Gamma-Brazil isolated forms. Recent governance in the United States issues lax regulatory guidelines prematurely aimed to negate a mask mandate that properly protects citizens from the harmful effects of the readily acquired virus, even among those who are fully vaccinated. Young children in schools are being forced to be exposed to the deleterious effects of the virus, regardless of their underlying comorbidities, placing them at grave risk. The purpose of this article is to elucidate the benefits of mask-wearing as an effective, non-pharmacologic intervention to prevent the onset of disease acquisition across populations inclusive of youths primarily in closed environments.

Mode of transmission

The route of COVID-19 transmission predominates in the form of aerosolized respiratory droplets expelled via talking, breathing, singing or sneezing, where projection is amplified under vigorous conditions. Exposure is increased within close parameters, as large viral particulates fall to lower-lying surfaces and smaller, micro-particulate tend to remain suspended in the air increasing the likelihood of exposure and viral acquisition. Poor ventilation and close range exposure are key means of infection across all age groups.

Benefits of mask-wearing

The efficacy of mask-wearing in disease prevention was established in the 20th century, with origins dating back to proper sanitation practices of early European civilization. In terms of benefits, the proper use of mask-wearing greatly reduces and limits viral particulate inhalation and exhalation, as normal speaking yields many aerosolized and droplet transmitting pathogens. With the proper use of masks, about 95 percent of viral transmission is decreased within a 6-foot radius; additionally, oral-fecal transmission is also reduced due to a decrease in surface-hand-to-mouth contact.

A study conducted indicated strong evidence that supports decreased risk of infection post-mask-wearing, as well as reduced the risk of acquisition by 70 percent; findings were substantiated by randomized control trials, meta-analysis, and systematic reviews of unbiased observations.

Similarly, Canadian studies indicated mandates in indoor mask-wearing decreased new COVID-19 diagnoses by 25 to 40 percent across the surveyed population. Parallel to direct positive medical impact due to onset of disease acquisition, societal effects include decreased incidences of stringent isolation and quarantine measures along with viral spread to vulnerable populations. On a grand scheme, mask-wearing regardless of vaccination status promotes social distancing, serves as a reminder for proper hand hygiene compliance, and discourages constant hand-to-mouth contact, all of which dissociate viral acquisition. A decrease in additional viral respiratory droplet onset that comprises seasonal human viruses like influenza, rhino, and coronaviruses are also negated due to particulate filtration regardless of mask composition.

Minor disadvantages

Despite the slew of senseless advantages that promote healthful living in a pandemic, some disadvantages to mask-wearing exist. Visibility of the human face greatly affects social interactions, as full facial visibility provides data for significant personal identification, affords indicators of trustworthiness, age, sex, attractiveness, and speech analysis, especially for the auditorily impaired population. Various mask types may promote the onset of recurrent, bilateral headaches, increase skin temperature, as well as promote various dermal indications like acne and dermatitis onset.

Mask forms

With the increased prevalence of the Delta variant, there is much ambiguity in preferential mask material for superior COVID-19 prevention. The U.S. Center for Disease Control and Prevention (CDC) recommends the use of fabric masks for general public use, where non-fully vaccinated people should wear masks both in and outdoors in public locations especially in crowded areas with large gatherings. Additional mask types can be used for varying degrees of exposure to various co-morbid populations, in addition to vaccination status. Masks can be classified as full, half, or quarter masks. Cloth masks adequately trap respiratory droplets and are effective barriers that prevent droplet transmission; multiple layers of tightly woven cotton fabric is preferential. Proper wear guidelines advise a snug fit over the nose, mouth, and chin with minimal to no gap; warm air coming through the front of the mask is anticipated upon exhalation with no air from the lateral sides of the mask. Of equal importance is the proper storage and cleaning of the mask on a daily basis, which can be accomplished via machine or hand washing with proper drying with each extended use. Medical or surgical masks aim to protect the public from droplets and aerosols in addition to the filtration of large particles. N95 and KN95 masks are respirators that filter out both droplets and aerosolized particles as the wearer inhales; use is typically donned by health care workers and medical staff, yet benefits serve all populations.

Benefits across populations

With such supportive, beneficial evidence that elucidates the protective qualities of mask-wearing among both the vaccinated and unvaccinated population, the debate of issuing a mask mandate in school still remains in question. In terms of child mask hindrances, mask-wearing can be uncomfortable to children, hinder facial recognition, and can alter interpretation along with verbal and non-verbal communication amongst students, peers, and teachers. Nevertheless, adequate implementation among compliant youth can significantly decrease the onset of asymptomatic COVID-19 outbreak without detracting from other viral prevention methods like vaccines.

Vishwani Persaud-Sharma is a nurse practitioner. 

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