Effective Use of Cloth Masks in Prevention to Control COVID 19

Ever since the outbreak of Corona Virus happened, the demand of medical masks, cotton masks and respirators have increased enormously.

History of Cloth Masks

In the beginning of the 20th century, various types of masks (made of cotton, gauze, and other fabrics) were in use in the US hospitals. Cloth masks were also used to protect healthcare workers from diphtheria and scarlet fever. In the year 1918 Spanish influenza pandemic took place, masks made of various layers of cotton were tremendously used by healthcare workers and the general public.

During the 1930s and 1940s, gauze and cloth masks were also used by healthcare workers to protect themselves from tuberculosis. During the mid of the 20th century, after disposable medical masks were developed, usage of cloth masks depleted. However, cloth mask use is still widespread in many countries in Asia. During the outbreak of Covid-19, cotton masks were widely used by healthcare workers and the general public; many significant studies have found them to be effective.

Cloth masks have been used in healthcare and community settings to protect the wearer from respiratory infections. The use of cloth masks during the coronavirus disease (COVID-19) pandemic is under debate. The filtration effectiveness of cloth masks is generally lower than that of medical masks and respirators; however, cloth masks may provide some protection if well designed and used correctly. Multilayer cloth masks, designed to fit around the face and made of water-resistant fabric with a high number of threads and finer weave, may provide reasonable protection. Until a cloth mask design is proven to be equally effective as a medical or N95 mask, wearing cloth masks should not be mandated for healthcare workers. In community settings, however, cloth masks may be used to prevent community spread of infections by sick or asymptomatically infected persons, and the public should be educated about their correct use.

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As a result of the Covid-19, supplies of medical masks and respirators are limited globally. Medical masks and respirators are commonly used as protection against respiratory and other infections. The main difference in these 2 products is the way they are used.

Though cloth masks are used to protect healthcare workers and the general public from varied respiratory infections. The rates of infection were consistently higher among those using the cloth mask group than in the medical mask and control groups.

The research reflects that the risk of infection is higher for those wearing fabric masks. The mask tested was a locally manufactured, double-layered cotton mask. A few people were given some cloth masks for a period of 1 month and were asked to wash them daily with soap and water. The poor performance may have been because the masks were not washed often or because they became wet and contaminated. Medical and cloth masks were used by some people in a small group, but the poor performance of cloth masks resulted in post analysis when compared with other people who use medical masks and others who only used a cloth mask.

It was found that the effectiveness of cloth masks is generally less than that of medical masks and respirators. The effectiveness of cloth masks varies, some materials filter better than others. The effectiveness of filtration of cloth masks depends on various factors, such as thread count, number of layers, type of fabric, and water resistance. A study tested medical masks and several household materials for the ability to bacterial and viral aerosols. Another study found that homemade cloth masks may also reduce aerosol exposure. Masks made from cotton and towel provides better protection than the masks made from gauze. Although cloth masks are often not designed to fit around the face, some materials may fit snugly against the face.

Cloth masks can be produced in large quantities in a considerably short time. They can be reused after being decontaminated through various methods, ideally washing them with hot water and soap. Other methods or products include using bleach, isopropyl alcohol, or hydrogen peroxide; and application of ultraviolet radiation or dry heat. Quite unlike, the disposable medical masks and respirators, the material of cloth masks is not likely to degrade from standard decontamination procedures. Though the hospitals will have an extra burden of cleaning and decontaminating used masks. If healthcare workers perform decontamination themselves, they may fail to wash masks frequently enough and may be at a risk of self-contamination.

During any pandemic, cloth masks should not be the only option available, they must only be used as a last resort when medical masks or respirators are not available. Cloth masks use should not be mandatory for healthcare workers, but some may choose to use them if they do not have any alternatives available. Current studies reflect that multilayered masks with water-resistant fabric, high number of threads and finer weave are more protective.


The filtration, effectiveness, fit, and performance of cloth masks are inferior to those of medical masks and respirators. Cloth mask use should not be made mandatory for healthcare workers, they should be provided proper respiratory protection as a priority. Cloth masks are a more suitable option for general community use when medical masks are unavailable. Protection provided by cloth masks can be improved by selecting appropriate material, increasing the number of mask layers and only using those with a design that provides filtration and fit. Cloth masks should be washed on daily basis and after high-exposure wash them using soap and hot water for better protection.
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