Millions of Lives Saved with Intelligent Mask Program

More than 55 million people have contracted COVID-19 globally and 1.3 million? have died. More than 3 million more people will die in the next 13 months unless policies change.

Many of these of lives can be saved by an intelligent mask program. Acceleration of the use of 93% rated CATE masks combined with decreasing use of 49% rated CATE masks and restrictions against 20% rated CATE masks are what is needed. A combination of vaccines and masks can provide the equivalent of herd immunity (70%) by July of next year.

Experts are unanimous in their belief that masks can save millions of lives in the next 13 months. But this is like saying that drugs can save millions of lives. This statement may be true but only if the right masks are worn. Some masks provide no protection. The belief that these masks capture large cough and sneeze droplets is valid but there are two big problems.

·       Most virus is transmitted in small droplets through breathing and talking

·       Large droplets temporarily captured evaporate and transmit the virus on a delayed basis

The idea that all masks are created equal has been as responsible for infections as the idea that masks are not important or that mandates unfairly violate civil rights. It is therefore imperative that the public understand differences between masks and wear ones which provide protection as well as reduce transmission.

There are four aspects of masks which are important.

·       Comfort: People will not wear masks all day if they are not comfortable.

·       Attractiveness:  As a major article of clothing an attractive mask will be used more than an unattractive one.

·       Tight Fit:  It is very difficult to achieve a tight. But if 50% of the air leaks around the mask 50% of the virus will as well.

·       Efficiency: Many masks claim high removal efficiency on viruses which are the size of perfume or smoke. But unless valid performance tests are available the efficiency is questionable.

These four important aspects form an acronym. CATE masks are what every person will want to have. There are many reusable versions of CATE masks which make them affordable even it the initial price is 30 times that of a disposable mask.

If everyone were to start wearing masks with a 93% CATE rating tomorrow most of the transmission would stop and millions of lives would be saved. This may not be possible immediately. But within six months everyone could have 93% rated CATE masks.  In the meantime there are sufficient 49% rated CATE masks to be used where the 93% rated masks are not available. It will be equally important to warn people against using masks with a rating below 20%. They provide access to restricted areas and therefore result in more infections than if they were not available

So governments who are already mandating masks have to clarify their policies. They should provide guidance which minimizes restrictions for those with 93% rated masks. The guidance should provide more limited access to those with 49% rated CATE masks. They should prohibit access to those with 20% rated CATE masks as they now do for people with no masks.

Since CATE masks are reusable the cost per wearing is low. The fastest and best way to implement this program is not through government purchases but just through guidance and stipulations regarding mask use. The funding can be part of the general support programs already available in most countries.

The private sector has the capability to quickly ramp up production. This can be done cost effectively even though the market will surge and then shrink in 2022. The key is use of materials and resources already supplied in other markets. So this becomes just one more application for a product rather than the sole market. Even with billions of people wearing reusable masks the weight of non wovens being consumed will be tiny compared to diapers, wipes, or other high-volume products.

The technology is also highly developed.  93% CATE masks have been used for years for air pollution protection, wildfires, pollen and immune depressed conditions

Millions of Lives at Risk

The death toll in the United States, currently at 244,250, could nearly double by March 1 to 438,971, the Institute for Health Metrics and Evaluation (IMHE) at the University of Washington’s School of Medicine forecasted in its latest projection.

Add Europe, which is in the midst of a second wave of infections, and the rest of the world, and the global death toll could reach a staggering 2.8 million by March 1, the IMHE projected.

“When you see that Europe is already up to 4,000-plus deaths a day, and it just keeps growing. We’re on a similar trajectory,” Dr. Christopher Murray, a professor of health metrics sciences at the University of Washington and director of the IHME, told NBC News. “We’re just about four weeks behind."

More than a half million lives could be lost to COVID-19 by 28 February 2021 in the USA, suggests a modeling study published in Nature Medicine. The paper also estimates that universal mask use could prevent the worst effects of epidemic resurgences in many states and could save nearly 130,000 of those half million lives.

The first major impact of vaccines will be in the second quarter 2020. So, by July 1, 2021 twenty percent of the world could be vaccinated.  This could reach 50% by the end of 2021.  By that point in time the U.S. deaths could reach 800,000 or more. World death tolls could reach 5 million people.

Billions of Masks Needed to Achieve Herd Immunity

CATE is an acronym for Comfortable, Attractive, Tight Fitting, Efficient. These masks have been available for many years to combat air pollution, wildfires and pollen. they are the ideal selection for the general public in the fight against COVID.  Here are the numbers.

In a room where people are social distancing at six feet and MERV 8 filters are used in an HVAC system with three air changes per hour unmasked individuals will be generating a cloud of virus particles similar to perfume or cigarette smoke. If masks are worn by transmitters as well as recipients, the net protection is a combination of the performance of both masks.

The net effectiveness is a function of the potential capability of the mask minus failure to achieve a tight fit and periods where the mask is discarded due to discomfort or social drivers. When all is considered the CATE mask combination is 93% effective compared to only 49% for the cloth mask.

Mask type: CATE masks are generally reusable and have various features to make them attractive, tight fitting and comfortable as well as efficient. Surgical masks are efficient but not tight fitting. N95 masks can be fitted for a tight seal but when worn by general public they are often not used properly.  Cloth masks can excel in comfort and attractiveness but are loose fitting and inefficient.

Direct Leakage: This is the amount of air which is exhaled around the mask directly.

Re-entrainment: Droplets initially captured on masks evaporate and split causing virus to escape.

Penetration: This relates to the efficiency of the filter media.

Use Discount: Masks should be worn as appropriate. Cloth and CAT masks are more comfortable than the others and are more likely to be used in borderline situations.

Recipient Load: This is the virus escaping the transmitter mask.

In Leakage: This is the amount inhaled around the mask seals.

There is no question that tight fitting efficient masks are the most effective weapon against COVID. These masks prevented any U.S. medical staff fighting Ebola to become infected. The COVID incidence among medical personnel in high COVID environments is very low. In cases where these personnel had no choice but loose fitting surgical masks the infection rate was high. If a comfortable, attractive version is available to the general public the battle can be easily won.

A combination of masks and vaccinations can create herd immunity quickly. It will be a combination of CATE, surgical and medium efficiency cloth masks. It will not include inefficient cloth masks.

Because CATE masks are tight flitting, efficient, comfortable and attractive they will be 93% effective where utilized. It was determined that only 1 mask would be needed per quarter due to reusability.  This will be the most cost-effective option. 

The surgical masks have high filtration efficiency but lots of leakage. The assumption is that the usage will be just one per day or 90 per quarter. To meet the needs of the world on July 1 2021 with 20% of the 6 billion active people vaccinated there would be a demand for 378 billion masks per quarter. This reduces to just under 38 billion by July of 2022. Since meltblowns are typically used in surgical masks and there is a big investment and delay in building new melt blown lines it is very unlikely that the suppliers would or could gear up for a market which will peak in the next year and then shrink substantially.

The cloth masks range in efficiency. In the example below we have selected relatively efficient designs. Many would have a 90% inefficiency rating. We have selected reusable masks in the $15-30 price range.  Even with a 51% inefficiency rating it would not be possible to achieve herd immunity with only 20% of the people vaccinated. You would need to mask 102% of the active population.

Herd immunity could be achieved by July 2022 if 10% of the active people are wearing cloth masks and 65% are protected through vaccinations. However, of the 5% who are not vaccinated, probably half are in fear of side effects. These people will be ones who will want CATE masks rather than cloth masks because of the higher protection.

Because of the huge immediate needs quick herd immunity will only take place with some mix of CATE, Surgical, and Cloth masks. But it is achievable. The Biden Administration is considering a mask mandate. Many countries already have them. The problem is that without specifying effectiveness some people are wearing masks which provide almost no protection.

One way to achieve herd immunity would be to specify CATE masks for those who are at most risk and allow surgical and cloth masks for others. However, for those masks with lower effectiveness some specification must be set. It should be some combination of maximum  penetration plus leakage. Europe has some community mask specifications set around 80% efficient media. However, without fit being included the specifications are inadequate.

The requirements can be based on expected load factors. CATE masks could be required in subways and theaters. Lower efficiency levels could be allowed for walking suburban streets or in grocery stores which have HEPA filtration and laminar air flow at checkout counters. This means that people may carry several masks and use the one appropriate for the setting.

The requirements can be synchronized with the production capabilities of suppliers. If the guidelines are set appropriately, we could have herd immunity in six months and save many hundreds of thousands of lives.

Details on mask technology and performance are included in Coronavirus Technology Solutions

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