A fluid mechanics explanation of the effectiveness of common materials for respiratory masks

Modeling virus transport and dynamics in viscous flow medium

In this paper, we developed a mathematical model to simulate virus transport through a viscous background flow driven by the natural pumping mechanism. Two types of respiratory pathogens viruses (SARS-Cov-2 and Influenza-A) are considered in this model. The Eulerian-Lagrangian approach is adopted to examine the virus spread in axial and transverse directions. The Basset-Boussinesq-Oseen equation is considered to study the effects of gravity, virtual mass, Basset force, and drag forces on the viruses transport velocity. The results indicate that forces acting on the spherical and non-spherical particles during the motion play a significant role in the transmission process of the viruses. It is observed that high viscosity is responsible for slowing the virus transport dynamics. Small sizes of viruses are found to be highly dangerous and propagate rapidly through the blood vessels. Furthermore, the present mathematical model can help to better understand the viruses spread dynamics in a blood flow.

Comparison of homemade mask designs based on calculated infection risk, using actual COVID-19 infection scenarios

During pandemics such as COVID-19, shortages of approved respirators necessitate the use of alternative masks, including homemade designs. The effectiveness of the masks is often quantified in terms of the ability to filter particles. However, to formulate public policy the efficacy of the mask in reducing the risk of infection for a given population is considerably more useful than its filtration efficiency (FE). The effect of the mask on the infection profile is complicated to estimate as it depends strongly upon the behavior of the affected population. A recently introduced tool known as the dynamic-spread model is well suited for performing population-specific risk assessment. The dynamic-spread model was used to simulate the performance of a variety of mask designs (all used for source control only) in different COVID-19 scenarios. The efficacy of different masks was found to be highly scenario dependent. Switching from a cotton T-shirt of 8% FE to a 3-layer cotton-gauze-cotton mask of 44% FE resulted in a decrease in number of new infections of about 30% in the New York State scenario and 60% in the Harris County, Texas scenario. The results are valuable to policy makers for quantifying the impact upon the infection rate for different intervention strategies, e.g., investing resources to provide the community with higher-filtration masks.

Electrospun transparent nanofibers as a next generation face filtration media: A review

The development of fascinating materials with functional properties has revolutionized the humankind with materials comfort, stopped the spreading of diseases, relieving the environmental pollution pressure, economized government research funds, and prolonged their serving life. The outbreak of Coronavirus Disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has triggered great global public health concern. Face masks are crucial tools to impede the spreading of SARS-CoV-2 from human to human. However, current face masks exhibit in a variety of colors (opaque), like blue, black, red, etc., leading to a communication barrier between the doctor and the deaf-mute patient when wearing a mask. High optical transparency filters can be utilized for both personal protection and lip-reading. Thus, shaping face air filter into a transparent appearance is an urgent need. Electrospinning technology, as a mature technology, is commonly used to form nanofiber materials utilizing high electrical voltage. With the alteration of the diameters of nanofibers, and proper material selection, it would be possible to make the transparent face mask. In this article, the research progress in the transparent face air filter is reviewed with emphasis on three parts: mechanism of the electrospinning process and light transmission, preparation of transparent face air filter, and their innovative potential. Through the assessment of classic cases, the benefits and drawbacks of various preparation strategies and products are evaluated, to provide general knowledge for the needs of different application scenarios. In the end, the development directions of transparent face masks in protective gear, particularly their novel functional applications and potential contributions in the prevention and control of the epidemic are also proposed.

Functional Textile Materials for Blocking COVID-19 Transmission

The outbreak of COVID-19 provided a warning sign for society worldwide: that is, we urgently need to explore effective strategies for combating unpredictable viral pandemics. Protective textiles such as surgery masks have played an important role in the mitigation of the COVID-19 pandemic, while revealing serious challenges in terms of supply, cross-infection risk, and environmental pollution. In this context, textiles with an antivirus functionality have attracted increasing attention, and many innovative proposals with exciting commercial possibilities have been reported over the past three years. In this review, we illustrate the progress of textile filtration for pandemics and summarize the recent development of antiviral textiles for personal protective purposes by cataloging them into three classes: metal-based, carbon-based, and polymer-based materials. We focused on the preparation routes of emerging antiviral textiles, providing a forward-looking perspective on their opportunities and challenges, to evaluate their efficacy, scale up their manufacturing processes, and expand their high-volume applications. Based on this review, we conclude that ideal antiviral textiles are characterized by a high filtration efficiency, reliable antiviral effect, long storage life, and recyclability. The expected manufacturing processes should be economically feasible, scalable, and quickly responsive.

Protective behavior and SARS-CoV-2 infection risk in the population - Results from the Gutenberg COVID-19 study

BACKGROUND

During the SARS-CoV-2 pandemic, preventive measures like physical distancing, wearing face masks, and hand hygiene have been widely applied to mitigate viral transmission. Beyond increasing vaccination coverage, preventive measures remain urgently needed. The aim of the present project was to assess the effect of protective behavior on SARS-CoV-2 infection risk in the population.

METHODS

Data of the Gutenberg COVID-19 Study (GCS), a prospective cohort study with a representative population-based sample, were analyzed. SARS-CoV-2 infections were identified by sequential sampling of biomaterial, which was analyzed by RT-qPCR and two antibody immunoassays. Self-reported COVID-19 test results were additionally considered. Information on protective behavior including physical distancing, wearing face masks, and hand hygiene was collected via serial questionnaire-based assessments. To estimate adjusted prevalence ratios and hazard ratios, robust Poisson regression and Cox regression were applied.

RESULTS

In total, 10,250 participants were enrolled (median age 56.9 [43.3/68.6] years, 50.8% females). Adherence to preventive measures was moderate for physical distancing (48.3%), while the use of face masks (91.5%) and the frequency of handwashing (75.0%) were high. Physical distancing appeared to be a protective factor with respect to SARS-CoV-2 infection risk independent of sociodemographic characteristics and individual pandemic-related behavior (prevalence ratio [PR] = 0.77, 95% confidence interval [CI] 0.62-0.96). A protective association between wearing face masks and SARS-CoV-2 transmission was identified (PR = 0.73, 95% CI 0.55-0.96). However, the protective effect declined after controlling for potential confounding factors (PR = 0.96, 95% CI 0.68-1.36). For handwashing, this investigation did not find a beneficial impact. The adherence to protective behavior was not affected by previous SARS-CoV-2 infection or immunization against COVID-19.

CONCLUSION

The present study suggests primarily a preventive impact of physical distancing of 1.5 m, but also of wearing face masks on SARS-CoV-2 infections, supporting their widespread implementation. The proper fit and use of face masks are crucial for effectively mitigating the spread of SARS-CoV-2 in the population.

Elucidating the role of environmental management of forests, air quality, solid waste and wastewater on the dissemination of SARS-CoV-2

The increasing frequency of zoonotic diseases is amongst several catastrophic repercussions of inadequate environmental management. Emergence, prevalence, and lethality of zoonotic diseases is intrinsically linked to environmental management which are currently at a destructive level globally. The effects of these links are complicated and interdependent, creating an urgent need of elucidating the role of environmental mismanagement to improve our resilience to future pandemics. This review focused on the pertinent role of forests, outdoor air, indoor air, solid waste and wastewater management in COVID-19 dissemination to analyze the opportunities prevailing to control infectious diseases considering relevant data from previous disease outbreaks. Global forest management is currently detrimental and hotspots of forest fragmentation have demonstrated to result in zoonotic disease emergences. Deforestation is reported to increase susceptibility to COVID-19 due to wildfire induced pollution and loss of forest ecosystem services. Detection of SARS-CoV-2 like viruses in multiple animal species also point to the impacts of biodiversity loss and forest fragmentation in relation to COVID-19. Available literature on air quality and COVID-19 have provided insights into the potential of air pollutants acting as plausible virus carrier and aggravating immune responses and expression of ACE2 receptors. SARS-CoV-2 is detected in outdoor air, indoor air, solid waste, wastewater and shown to prevail on solid surfaces and aerosols for prolonged hours. Furthermore, lack of protection measures and safe disposal options in waste management are evoking concerns especially in underdeveloped countries due to high infectivity of SARS-CoV-2. Inadequate legal framework and non-adherence to environmental regulations were observed to aggravate the postulated risks and vulnerability to future waves of pandemics. Our understanding underlines the urgent need to reinforce the fragile status of global environmental management systems through the development of strict legislative frameworks and enforcement by providing institutional, financial and technical supports.

A Physical Analog to Assess Surgical Face Mask Air Flow Resistance During Tidal Ventilation

A large variety of disposable face masks have been produced since the onset of the COVID-19 pandemic. Decreased resistance to inspiration improves adherence to the use of the mask; the so called breathability is usually estimated by the measurement of air flow across a section of the tissue under a given pressure difference. We hypothesized that the mask pressure—flow relationship studied in conditions that mimic tidal breathing could allow a more comprehensive characterization of airflow resistance, a major determinant of mask comfort. A physical analog was made of a plaster cast dummy head connected through a pneumotachograph to a series of bellows inflated/deflated by a respirator. Pressure was measured at the mock airway opening over which the mask was carefully secured. The precision of the measurement equipment was quantified using two estimates of measurement error: repeatability coefficient (RC) and within-mask coefficient of variation (CV_wm). The airflow resistance of 10 surgical masks was tested on 4 different days. Resistance means did not differ significantly among four repeated measures (0.34 hPa.s.L⁻¹; 0.37 hPa.s.L⁻¹; 0.37 hPa.s.L⁻¹; and 0.37 hPa.s.L⁻¹; p = 0.08), the estimated RC was 0.08 hPa.s.L⁻¹ [95%CI: 0.06–0.10 hPa.s.L⁻¹], and CV_wm was 8.7% [95%CI: 1.5–12.2%]. Multiple comparisons suggest the presence of a learning effect by which the operator reduced the error over the course of repetitive resistance measurements. Measurement precision improved considerably when the first set of measures was not taken into account [RC ~ 0.05 hPa.s.L⁻¹ (95%CI: 0.03–0.06 hPa.s.L⁻¹); CV_wm~4.5% (95%CI: 1.9–6.1%)]. The testing of the face mask resistance (R) appears simple and highly repeatable in conditions that resemble tidal breathing, once operator training was assured. The procedure adds further to the current standard assessment of breathability and allows estimating the maximal added respiratory load, about 10–20% of the respiratory resistance reported in heathy adult subjects.

High efficacy of layered controls for reducing exposure to airborne pathogens

To optimize strategies for curbing the transmission of airborne pathogens, the efficacy of three key controls-face masks, ventilation, and physical distancing-must be well understood. In this study, we used the Quadrature-based model of Respiratory Aerosol and Droplets to quantify the reduction in exposure to airborne pathogens from various combinations of controls. For each combination of controls, we simulated thousands of scenarios that represent the tremendous variability in factors governing airborne transmission and the efficacy of mitigation strategies. While the efficacy of any individual control was highly variable among scenarios, combining universal mask-wearing with distancing of 1 m or more reduced the median exposure by more than 99% relative to a close, unmasked conversation, with further reductions if ventilation is also enhanced. The large reductions in exposure to airborne pathogens translated to large reductions in the risk of initial infection in a new host. These findings suggest that layering controls is highly effective for reducing transmission of airborne pathogens and will be critical for curbing outbreaks of novel viruses in the future.

Infrared-based visualization of exhalation flows while wearing protective face masks

Since the onset of the COVID-19 pandemic, a large number of flow visualization procedures have been proposed to assess the effect of personal protective equipment on respiratory flows. This study suggests infrared thermography as a beneficial visualization technique because it is completely noninvasive and safe and, thus, can be used on live individuals rather than mannequins or lung simulators. Here, we examine the effect of wearing either of three popular face coverings (a surgical mask, a cloth mask, or an N95 respirator with an exhalation valve) on thermal signatures of exhaled airflows near a human face while coughing, talking, or breathing. The flow visualization using a mid-wave infrared camera captures the dynamics of thermal inhomogeneities induced by increased concentrations of carbon dioxide in the exhaled air. Thermal images demonstrate that both surgical and cloth face masks allow air leakage through the edges and the fabric itself, but they decrease the initial forward velocity of a cough jet by a factor of four. The N95 respirator, on the other hand, reduces the infrared emission of carbon dioxide near the person's face almost completely. This confirms that the N95-type mask may indeed lead to excessive inhalation of carbon dioxide as suggested by some recent studies.

Assessment of cloth masks ability to limit Covid-19 particles spread: a systematic review

After the spread of Covid 19 worldwide, the use of cloth masks increased significantly due to a shortage of medical masks. Meanwhile, there were different opinions about the effectiveness of these masks and, so far, no study has been done to find the best fabric masks. This study reviews and summarizes all studies related to fabric masks' effectiveness and various fabrics against coronavirus. This systematic review is based on PRISMA rules. Two researchers separately examined three databases: PubMed, Scopus, and Web of Science. Laboratory and clinical studies were included. After extracting the articles, their quality was assessed with the Joanna Briggs Institute (JBI) tool. In addition to efficacy, other factors, including the penetration of masks, pressure drop, and quality factor, were examined to select the best fabrics. Of the 42 studies selected, 39 were laboratory studies, and 3 were clinical studies. Among the various fabrics examined, cotton quilt 120 thread per inch (TPI), copy paper (bonded), hybrid of cotton with chiffon/ silk, and flannel filtration were found to have over 90% effectiveness in the particle size range of Covid-19. The results and comparison of different factors (pressure drop, filtration efficacy, penetration, filtration quality, and fit factor have been evaluated) showed that among different fabrics, hybrid masks, 2-layered cotton quilt, 2-layered 100% cotton, cotton flannel, and hairy tea towel + fleece sweater had the best performance. Clinical studies have not explicitly examined cloth masks' effectiveness in Covid-19, so the effectiveness of these types of masks for Covid 19 is questionable, and more studies are needed.

Protective Face Masks: Current Status and Future Trends

Management of the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has relied in part on the use of personal protective equipment (PPE). Face masks, as a representative example of PPE, have made a particularly significant contribution. However, most commonly used face masks are made of materials lacking inactivation properties against either SARS-CoV-2 or multidrug-resistant bacteria. Therefore, symptomatic and asymptomatic individuals wearing masks can still infect others due to viable microbial loads escaping from the masks. Moreover, microbial contact transmission can occur by touching the mask, and the discarded masks are an increasing source of contaminated biological waste and a serious environmental threat. For this reason, during the current pandemic, many researchers have worked to develop face masks made of advanced materials with intrinsic antimicrobial, self-cleaning, reusable, and/or biodegradable properties, thereby providing extra protection against pathogens in a sustainable manner. To overview this segment of the remarkable efforts against COVID-19, this review describes the different types of commercialized face masks, their main fabrication methods and treatments, and the progress achieved in face mask development.

Simulating near-field enhancement in transmission of airborne viruses with a quadrature-based model

Some infectious diseases, such as influenza, tuberculosis, and SARS-CoV-2, may be transmitted when virus-laden particles expelled from an infectious person are inhaled by someone else, which is known as the airborne transmission route. These virus-laden particles are more concentrated in the expiratory jet of an infectious person than elsewhere in a well-mixed room, but this near-field enhancement in virion exposure has not been well quantified. Transmission of airborne viruses depends on factors that are inherently variable and, in many cases, poorly constrained, and quantifying this uncertainty requires large ensembles of model simulations that span the variability in input parameters. However, models that are well-suited to simulate the near-field evolution of respiratory particles are also computationally expensive, which limits the exploration of parametric uncertainty. In order to perform many simulations that span the wide variability in factors governing airborne transmission, we developed the Quadrature-based model of Respiratory Aerosol and Droplets (QuaRAD). QuaRAD is an efficient framework for simulating the evolution of virus-laden particles after they are expelled from an infectious person, their deposition to the nasal cavity of a susceptible person, and the subsequent risk of initial infection. We simulated 10 000 scenarios to quantify the risk of initial infection by a particular virus, SARS-CoV-2. The predicted risk of infection was highly variable among scenarios and, in each scenario, was strongly enhanced near the infectious individual. In more than 50% of scenarios, the physical distancing needed to avoid near-field enhancements in airborne transmission was beyond the recommended safe distance of two meters (six feet) if the infectious person is not wearing a mask, though this distance defining the near-field extent was also highly variable among scenarios; the variability in the near-field extent is explained predominantly by variability in expiration velocity. Our findings suggest that maintaining at least two meters of distance from an infectious person greatly reduces exposure to airborne virions; protections against airborne transmission, such as N95 respirators, should be available when distancing is not possible.

Impact on airborne virus behavior by an electric heat pump (EHP) operation in a restaurant during winter season

The world is having an unprecedented time due to the pandemic. Currently, more than 93 million people have been infected, and over 2 million people have passed away since 2020. SARS-CoV-2 has forced people to change their lifestyles and patterns. Under the pandemic, buildings are no longer safe shelters. The infected transmit infectious viruses to other occupants by direct contact or indirect contact (i.e., indoor airflow). In addition, the airflow from electric heat pump systems can propel indirect contact in indoor spaces. However, the impact of airflow is still not sufficiently identified to develop virus control strategies in buildings. Therefore, this study selected a restaurant in Seoul, Korea, to experiment with airborne virus transmission of direct airflow in winter using virus-similar particles. The results of this study verified the potential exposure of droplets or aerosols to occupants that can be delivered by air current from heating systems in winter. The effect of kitchen hoods was also confirmed as additional ventilation equipment without additional budget investment in restaurants. The recommendations of this study are expected to improve the guidelines for restaurants to ensure occupant's safety during the COVID-19 period.

In-House Filtration Efficiency Assessment of Vapor Hydrogen Peroxide Decontaminated Filtering Facepiece Respirators (FFRs)

To cope with the shortage of filtering facepiece respirators (FFRs) caused by the coronavirus disease (COVID-19), healthcare institutions have been forced to reuse FFRs using different decontamination methods, including vapor hydrogen peroxide (VHP). However, most healthcare institutions still struggle with evaluating the effect of VHP on filtration efficiency (FE) of the decontaminated FFRs. We developed a low-cost in-house FE assessment using a novel 3D-printed air duct. Furthermore, we assessed the FE of seven types of FFRs. Following 10 VHP cycles, we evaluated the FE of KN95 and 3M-N95 masks. The 3M-N95 and Benehal-N95 masks showed significant lower FE (80.4-91.8%) at fine particle sizes (0.3-1 µm) compared to other FFRs (FE ≥ 98.1%, p < 0.05). Following 10 VHP cycles, the FE of KN95 masks was almost stable (FE stability > 99.1%) for all particle sizes, while 3M-N95 masks were stable only at 2 and 5 µm (FE stability > 98.0%). Statistically, FE stability of 3M-N95 masks at 0.3, 0.5, and 0.7 µm was significantly lower (p ≤ 0.006) than 2 and 5 µm. The in-house FE assessment may be used as an emergency procedure to validate the decontaminated FFRs, as well as a screening option for production control of FFRs. Following VHP cycles, both masks showed high stability at 5 µm, the size of the most suspected droplets implicated in COVID-19 transmission.

Experimental investigation of indoor aerosol dispersion and accumulation in the context of COVID-19: Effects of masks and ventilation

The ongoing COVID-19 pandemic has highlighted the importance of aerosol dispersion in disease transmission in indoor environments. The present study experimentally investigates the dispersion and build-up of an exhaled aerosol modeled with polydisperse microscopic particles (approximately 1 μm mean diameter) by a seated manikin in a relatively large indoor environment. The aims are to offer quantitative insight into the effect of common face masks and ventilation/air purification, and to provide relevant experimental metrics for modeling and risk assessment. Measurements demonstrate that all tested masks provide protection in the immediate vicinity of the host primarily through the redirection and reduction of expiratory momentum. However, leakages are observed to result in notable decreases in mask efficiency relative to the ideal filtration efficiency of the mask material, even in the case of high-efficiency masks, such as the R95 or KN95. Tests conducted in the far field ( 2   m distance from the subject) capture significant aerosol build-up in the indoor space over a long duration ( 10   h ). A quantitative measure of apparent exhalation filtration efficiency is provided based on experimental data assimilation to a simplified model. The results demonstrate that the apparent exhalation filtration efficiency is significantly lower than the ideal filtration efficiency of the mask material. Nevertheless, high-efficiency masks, such as the KN95, still offer substantially higher apparent filtration efficiencies (60% and 46% for R95 and KN95 masks, respectively) than the more commonly used cloth (10%) and surgical masks (12%), and therefore are still the recommended choice in mitigating airborne disease transmission indoors. The results also suggest that, while higher ventilation capacities are required to fully mitigate aerosol build-up, even relatively low air-change rates ( 2   h - 1 ) lead to lower aerosol build-up compared to the best performing mask in an unventilated space.

Advanced Research and Development of Face Masks and Respirators Pre and Post the Coronavirus Disease 2019 (COVID-19) Pandemic: A Critical Review

The outbreak of the COVID-19 pandemic, in 2020, has accelerated the need for personal protective equipment (PPE) masks as one of the methods to reduce and/or eliminate transmission of the coronavirus across communities. Despite the availability of different coronavirus vaccines, it is still recommended by the Center of Disease Control and Prevention (CDC), World Health Organization (WHO), and local authorities to apply public safety measures including maintaining social distancing and wearing face masks. This includes individuals who have been fully vaccinated. Remarkable increase in scientific studies, along with manufacturing-related research and development investigations, have been performed in an attempt to provide better PPE solutions during the pandemic. Recent literature has estimated the filtration efficiency (FE) of face masks and respirators shedding the light on specific targeted parameters that investigators can measure, detect, evaluate, and provide reliable data with consistent results. This review showed the variability in testing protocols and FE evaluation methods of different face mask materials and/or brands. In addition to the safety requirements needed to perform aerosol viral filtration tests, one of the main challenges researchers currently face is the inability to simulate or mimic true aerosol filtration scenarios via laboratory experiments, field tests, and in vitro/in vivo investigations. Moreover, the FE through the mask can be influenced by different filtration mechanisms, environmental parameters, filtration material properties, number of layers used, packing density, fiber charge density, fiber diameter, aerosol type and particle size, aerosol face velocity and concentration loadings, and infectious concentrations generated due to different human activities. These parameters are not fully understood and constrain the design, production, efficacy, and efficiency of face masks.