Tips for Mask-Wearing Crusaders

Nurses who value evidence-based practice know that wearing a mask can help save lives—but it can be a trial to get the message across and overcome the reluctance of patients, family, and friends. Of course, patient education is often an uphill battle, but what nurse can resist the pull of that phrase “help save lives?” Amid the flurry of confusion and anxiety-fueled misinformation, nurses enjoy a public trust that allows them a unique opportunity to fulfill their role as patient educators. Here are some basic considerations and information sources to help you become a leader in the mask-wearing crusade.

I Wear an N95 Mask for Most of My 12-Hour Shift, and YOU’RE Complaining About Discomfort?

Nurses have been donning gloves and surgical masks for 100 years now. Present-day 3-ply surgical masks are lightweight and ergonomic, and prior to the pandemic, you probably did not spend much time thinking about them. When an epidemic strikes, though, out come the N-95s (albeit in insufficient numbers)! And frankly, if an N95 is part of your daily gear—if you are coping with the extra effort of inhaling through those layers, bruising from the tight fit, or worrying that weeks of use has turned your “disposable” burden into a biohazard—well, it can be pretty hard to listen to someone gripe about wearing a surgical or cloth mask. After all, wearing shoes can be downright painful, but most people do not decide to throw away their footwear and take up a barefoot lifestyle.

It might help to keep in mind that for a non-clinician, having to wear a face cover—and live in a community where most people are masked—is not just inconvenient and uncomfortable; it is a shocking, alienating experience. Refusing to wear a mask is irrational, but that irrationality is fueled by fear and is often kindled by resentment. The challenge is to soothe that primitive, shock-induced fear and instill a healthier sort of fear: “what you should be afraid of is catching the virus and/or infecting your family: here’s something you can do to protect them and yourself.”

You Know the Evidence that Wearing a Mask Saves Lives: Share It!

Just as AIDS taught us that wearing condoms can save lives, covid-19 is teaching us to wear masks to protect ourselves and our communities during a respiratory-based viral pandemic. Numerous studies have linked the use of face masks with lower rates of infection, including a new one from the CDC indicating that mask mandated and social distancing curbed the summer Arizona outbreak by 75%. We have also seen that even where there is extensive and regular testing, communities that frown on face masks are extremely vulnerable to COVID. In July, both the ANA and the AANP issued statements urging the public to heed the evidence and wear masks. Citing a June 27 Lancet article, AANP president Sophia L. Thomas said, “Research shows that wearing a mask results in a 65%-85% reduction in the wearer’s risk of contracting infections. Let us pledge to do our part to protect each other.” Some good sources to share include:

“I Used to Call it the ‘Scamdemic:’” – Washington Post Covid-19 oral history series
Masks Mandates Have Major Impact – MIT
Face Masks Really Do Matter, Wall Street Journal
Widespread Use of Masks Could Drive Down NY Death Rate – Newsday
Face Masks Could Save Tens Of Thousands Of Lives – NPR
Study Finds Face Masks Prevented Thousands of COVID0-19 Cases – KMBC

You can stay up to date on new evidence by creating a Google Alert or searching for “face masks study” and clicking “tools” and selecting “past month.” This short blog post from the AACN offers some valuable tips for evaluating sources: https://www.aacn.org/blog/going-viral-covid-19-and-the-internet.

Raise Awareness of the Masking Dos and Don’ts

A mask is useless if it is not worn and handled properly. People adjust their masks with exposed hands, let their masks hanging off their chins, neglect to wash cloth masks daily, and wear disposable masks the way many nurses wear N95s: for weeks on end, but without the sterilization steps you take with clinical PPE. Make sure people know the basic “do this; don’t do that” points of mask-wearing. The National Foundation for Infectious Diseases says:

Do—wear masks in public and around people outside your households
Do—wash cloth masks daily
Do—make sure your mask fits snugly from nose to chin (and keep it there)
Don’t—remove a mask in public if other people are within six feet
Don’t—use a scarf, bandana, or gaiter, or wear a mask with gaps or valves that let air in or out
Don’t—use a mask that is soiled, damaged, or torn

Tis the Season to… Wear a Mask

Now that we are on the cusp of peak coronavirus season—and with Covid infections spiking around the country and the world—it’s time to remind people to be mindful and educate the misinformed. The onset of Fall/Winter weather is already thinning the ranks of patrons at the ad hoc sidewalk cafes that added a European flavor to so many US cities this past summer. Most al fresco activities are slacking off as the air chills, and as we spend more time indoors we ease the path of those infamous “crowned” viral particles. As a recent Stat article on Covid-19 and cold weather notes, “Studies show significantly more infections happen and spread when the relative humidity falls from between 40% and 60% — a range typical in warmer weather — to 20%. That research draws from past outbreaks of flu and MERS, which is caused by another coronavirus.”

An October MIT Technology Review article remarked that as yet, the virus has no established weather-based patterns: “the infection… peaked in some US cities, such as Boston, when temperatures were in the 40s and in others, such as Houston, when they were in the 90s,” but “epidemiological research from MIT, Harvard, Virginia Tech, and the University of Connecticut suggests the coronavirus likewise is more infectious in low relative humidity—anything below 40% will help the virus thrive. That’s bad news for most of the US, where relative humidity routinely drops as low as 15% on the coldest days, compared with typical indoor relative humidity of 50% to 70% in the summer.” As cases during the latest surge mount, we need to spread the word that by wearing a mask—and wearing it properly—is an essential component of a happy 2020 holiday season.