Is it time to upgrade the masks we use and require?

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Photo by Markus Winkler via Unsplash

This post originally appeared in the GNW COVID-19 Response Team email dated Jan. 12, 2022. Click here to subscribe.

There is a growing consensus among public health officers and medical experts that masking recommendations, including those currently offered by the CDC (now under review), need to be revisited with Omicron. We believe that it is time for individuals and ministry settings to consider what they can do to improve this practice as a part of their risk mitigation strategy.

At some level, both the choice to be vaccinated and the choice of masks are individual decisions. But those choices impact entire communities. Previously, we have recommended that churches encourage their members to get vaccinated and to assist in community efforts to vaccinate as many as possible. In that same spirit, we now recommend that our churches consider changes to their masking policies, educating their members and leading by example.

Our GNW COVID-19 Response Team has recommended a layered approach to risk mitigation through most of the pandemic. This approach is sometimes referred to as a “Swiss cheese model” as it expects holes or gaps in any single effort we might employ. Practiced together, the strategies make a situation or setting safer than any single measure – or what one might refer to as a silver bullet approach.

There is no better example of this than masking, as even the most highly protective masks literally have tiny holes that allow for air transfer through their layers. N95 and similarly rated masks (KN95, KF94), also called respirators, are so named to communicate that they filter up to 95% of very small (0.3 microns) particulates when properly fit to a face. This means that when used correctly – which we all appreciate as part of the struggle – high-quality masking is imperfect, even if it is very good.

The high transmissibility of Omicron has caused a growing number of epidemiologists and other medical experts to question the standard mantra that any mask is better than no mask. While this mantra isn’t wholly wrong, different types of masks offer vastly different protection levels.

Recently, the Wall Street Journal (WSJ) published a helpful article on this topic which I would recommend as it explains better the differences in types of masks while offering pointers on proper fit (if you have exhausted the number of free articles you can read from the WSJ, the USA Today articles I share below offer similar information). They shared the following chart based upon research data published by the American Conference of Governmental Industrial Hygienists (ACGIH).

While this chart is helpful in showing the range in effectiveness between different types of masking, two things must be noted. First, the data included was published by ADGIH in April of 2021 on research done before that, meaning that it considered the spread of coronavirus prior to Delta or Omicron. Second, and more importantly, this chart assumes good usage of each type of masking, which is not a safe assumption. This is one example of why the GNW COVID-19 Response Team recommends a layered approach even when a church leans hard into any single mitigation strategy.

– Wall Street Journal

Speaking from personal experience, I have used a KN95 respirator fairly religiously since shortages started to ease in 2020. While the KN95s peculiar beak-like appearance garnered a few strange looks when they were less common, I found the extra peace of mind worth it. Several experts were already calling the “any mask is better” strategy flawed.

Last week, USA Today published an article considering the science behind shifting recommendations toward N95 and KN95 respirators. As part of that discussion, they offer guidance on how such masks can be safely reused, as they cannot be cleaned as cloth masks can. My practice has been similar, although less careful in this area.

Another article from USA Today offered suggestions on where you can purchase respirators and what to look for to ensure you aren’t getting a counterfeit, as fake respirators have crowded the marketplace.

While the CDC continues to recommend a well-fit multi-layered cloth mask as an acceptable option, the chorus of voices arguing for better masking should cause us to revisit our personal and corporate masking recommendations. With a growing number of institutions starting to require a medical-grade mask (often surgical or higher-grade respirator masks), it may be a matter of time before some public health departments begin to require the same.

If your ministry setting has relaxed its posture regarding masking, Omicron’s pervasive spread should cause you to rethink this. If you are still meeting in person, consider requiring at least a surgical mask, purchasing them to have on hand for those who arrive without a mask or with a cloth mask without any additional filtration. For ministries that can find and afford them, offer a KN95 (or equivalent) respirator in their place.

If people wish to wear a cloth mask with a surgical mask, they should wear the surgical mask underneath the cloth mask as that may improve the fit. Double-masking is not advisable with some respirators, particularly KN95s as it is unlikely to improve the filtration and may compromise its effectiveness.

Ministries may also revisit how they can model better masking through the practice of church staff and essential volunteers. Those congregations offering in-person worship options with severe levels of the Omicron variant present may wish to reconsider the removal of masks even by those leading worship.

Finally, consider how you might educate your congregation (remote or in-person) by sharing information about better masking practices. Most church members spend most of their time in public in other settings besides church, and we should care about them wherever they are.

The pandemic continues to challenge us as new variants emerge and our beliefs about what we know are disrupted. As in so many areas of life and ministry, our openness and willingness to adapt to new information can be hard to maintain but also can reward us with better results.

Patrick Scriven, on behalf of the GNW COVID-19 Response Team

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