Analysis, Memories, Observations, People, Reflection

Wearing an N95 like a Cowboy Hat

A friend said something about how we need to normalize the use of N95-grade face-masks against COVID19. She thinks medical grade masks are helpful, even necessary, and should be worn by most people. Remember: Dunning-Kruger effect is not something that happens to “stupid people”; it happens to every person when their base of knowledge is in a certain range: knowing enough to feel competent but not enough to notice flaws. I hope it’s what’s happening to me! If I’m wrong, people of all types can use high-quality masks and stifle the spread of Delta-variant COVID19. That would be wonderful!

I wore N95 masks when I worked at a COVID19 testing laboratory (April, May & June 2021). Here is how we used them. Preparing to triage samples was a multistage sanitation-journey.

This was my experience:

  • I wear a cloth mask as I enter the building and ride to the third floor
  • I enter our office-space and register my temperature
  • I funnel saliva (pooled in my mouth on the elevator) into a sample tube
  • I wash my hands with soap
  • I enter the lab
  • …and get a long, white lab-coat
  • …put on rubbery-gloves and blue plastic sleeves to form a seal
  • …after that, hang my cloth mask carefully and play an N95 on my face
  • (safety glasses, a precaution against precautions since we use alcohol and bleach)

Before moving on, I want to linger over this sequence: my hands are totally clean, my street clothes are covered, then the clothes over my clothes form a seal with brand new gloves and sleeves, and then (only then) I pick-up my N95.

I kept the mask in place as much as I could but it was hellishly uncomfortable. My first week, I wore an N95 for more than 40 hours and it left an abrasion on the bridge of my nose. I used two band-aids, overlapped like shingles, so I could wear my mask properly until it no longer drew blood. My oversized nose might be to blame but I’m not the only person with a big shnoz.

The positivity rate among COVID19 tests at the time was just under 4% and I processed hundreds of samples that first week. I was constantly repositioning my mask using anything-but-my-gloves, took a slight risk every time. Yet all my tests came back negative and I think it was because of the ventilation hoods.

I might sound like a broken record when I say “COVID19 isn’t the flu” but let me introduce you to side-B of that record: COVID19 is more airborn than the flu but less hearty on surfaces. The alcohol or bleach we sprayed on our equipment was for COVID19 but also (really) for every other microbe haunting the samples. The ventilation hoods were a vital tool for keeping COVID19 contained.

The laboratory manager and technicians were fastidious about vent-hoods. Nothing moved from a cooler to a hood, from a hood to a refrigerator, or from any A-point to a B-point without being sealed in a plastic bag. We only exposed samples under the hoods. There was a slit between the glass barrier and the stainless-steel counter where I could insert my arms to work with samples; I opened the hood to move things in and out. If I left it open too wide, too long, the hood would beep incessantly until I slid the glass barrier back into position. Air-conditioning and ceiling fans blew continuously, too, scattering anything that escaped the sucking maw of a hood.

We placed our N95s on hangers when we took breaks. Our lab-manager — who administered a nasal sample on himself every day because it was the most reliable — he, too, wore cloth masks in the office. Anything that didn’t go under the hood (coats, glasses, masks) went on a hanger… everything that went under the hood was discarded as a biohazard. The lab was (is) a quarantined space and our N95s only existed there, apart from the world, until we discarded them.

My very cautious friend might think, “you should have a second N95 for the rest of the building, then.” There was a clinic in the building too. But an N95s is only superior to cloth masks if I faithfully maintain a seal on my face. The point of going on break is to unseal my face to eat and drink. I could spoil an N95 as easily as any other mask. A cloth mask is comfortable, washable, personalize-able, and serviceable for the task.

But I have to be humble: I know just a bit about this complex topic. I’m not going to tell my friend “you shouldn’t use N95s because they need to be saved for medical and laboratory personnel.” People who work or live with vulnerable populations might make a significant, positive impact by wearing a higher-grade mask.

Still, schools are going to be a mess. Kids will be doing very well if they mask faithfully. The higher-grade masks might just be an extra layer of suffering without a guarantee of more safety. Some kid, on some day, in some situation, is going to feel the irresistible urge to fuss with an uncomfortable N95. The ventilation hoods and the brisk airflow at the laboratory were not peripheral: those measures are what allowed us to put our coats and masks on hangers, exposing our faces briefly. Cloth masks might be better suited to the dungeons of public schools if kids are less likely adjust them too often.

What I’m emphasizing is that no one I met in that building felt as if wearing cloth masks during everyday life was insufficient. The most expert category of people — people both trained to work with disease and actively testing for it — were comfortable wearing cloth masks outside the lab. I don’t want us to start shaming people for wearing cloth masks. To be fair, everyone was both vaccinated and masking indoors.

BUT GET REAL:

We won’t be able to normalize N95s. Many folks aren’t motivated to seek them, nor trained well enough to use them effectively, and those of us who’ve worked in high-risk environments might hesitate to create a potential supply squeeze. I promised I wouldn’t discourage my one, cautious friend… but I’m discouraging the rest of you. Unless you’re reaching into a cooler full of test-tubes filled with spit and snot, or working in others’ personal space as part of your job, a high-grade mask isn’t doing as much to keep you safe as a six-feet-in-every-direction social-distancing-bubble does.

  • If you can’t distance yourself from the virus but can maintain a seal: N95
  • If you can socially distance but can’t maintain a constant seal: cloth mask
  • If there’s any doubt to which category you belong: two cloth masks 😉

Yeehaw, Paranoia!

I had fun recounting my laboratory days but medical facts are not my expertise. The idea of people wearing N95s on the street is weird to me — too surreal — I confess that’s my bias. It would be like wearing pajamas to the office..? Maybe more like donning my Phantom of the Opera half-mask..? Aha! It’s like wearing a cowboy hat on the DC Metro! That’s not a hat I would wear in public: too much brim, it’s out of place. I’d feel like a ninny.

I said all of that just to say this: fear has sway and we’re afraid of different things. I’m less afraid of getting mild COVID19 than I am of appearing like a ninny. I’m vaccinated (better than masks and ventilation hoods combined). There’s no point being a ninny until a more dangerous variant emerges.

But I need my al-quds masks— my black-and-white-kefia masks! I can’t wear just any mask! I must wear a mask that reminds me of where I’m willing to go and what I’m willing to do! When someone asks me “why are you wearing that mask?” I want to say “in solidarity with the people I worked with in Palestine,” and derail discussion about COVID19.

On the left, my favorite DC-metro radio station’s swag mask. I’m still a supporter!

If I wore an N95 everywhere, maybe no one would bother to ask “why?”— I’m afraid of that. If I see someone in extra PPE, I give them a wide-berth. If they truly need it, I don’t want to be exposed to whatever warrants THAT mask. If not, I don’t want to absorb that person’s sense of desperation.

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