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      Face masks against COVID-19: Standards, efficacy, testing and decontamination methods

      review-article
      a , b , a , b , *
      Advances in Colloid and Interface Science
      Elsevier B.V.
      COVID-19, SARS-CoV-2, Mask, Particle, Filtration, Decontamination, BFE, bacterial filtration efficiency, CDC, Centers for Disease Control and Prevention, COVID-19, coronavirus disease 2019, ECDC, European Centre for Disease Prevention and Control, EtO, ethylene oxide, FDA, Food and Drug Administration, FFR, filtering facepiece respirator, FFP, filtering facepiece, MGB, Mass General Brigham, MPPS, most penetrating particle size, NIOSH, National Institute for Occupational Safety and Health, NNU, National Nurses United, PFE, particle filtration efficiency, PM, particulate matter, PP, polypropylene, PPE, personal protective equipment, QNFT, quantitative fit test, R0, basic reproduction number, Rt, effective reproduction number, RH, relative humidity, RPE, respiratory protective equipment, SARS-CoV-2, acute respiratory syndrome coronavirus 2, TCID50, fifty-percent tissue culture infectious dose, TIL, total inward leakage, TPI, threads per inch, UN, United Nations, UV, ultraviolet, UVC, the UV spectrum with wavelength from 200 to 280 nm, UVGI, ultraviolet germicidal irradiation, VFE, viral filtration efficiency, VHP, vaporized hydrogen peroxide, WHO, World Health Organization, ΔP, differential pressure across a mask or filter material

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          Abstract

          Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the novel coronavirus disease 2019 (COVID-19), has caused a global pandemic on a scale not seen for over a century. Increasing evidence suggests that respiratory droplets and aerosols are likely the most common route of transmission for SARS-CoV-2. Since the virus can be spread by presymptomatic and asymptomatic individuals, universal face masking has been recommended as a straightforward and low-cost strategy to mitigate virus transmission. Numerous governments and public health agencies around the world have advocated for or mandated the wearing of masks in public settings, especially in situations where social distancing is not possible. However, the efficacy of wearing a mask remains controversial. This interdisciplinary review summarizes the current, state-of-the-art understanding of mask usage against COVID-19. It covers three main aspects of mask usage amid the pandemic: quality standards for various face masks and their fundamental filtration mechanisms, empirical methods for quantitatively determining mask integrity and particle filtration efficiency, and decontamination methods that allow for the reuse of traditionally disposable N95 and surgical masks. The focus is given to the fundamental physicochemical and engineering sciences behind each aspect covered in this review, providing novel insights into the current understanding of mask usage to curb COVID-19 spread.

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          Most cited references155

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          Stability of SARS-CoV-2 in different environmental conditions

          We previously reported the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in different clinical samples. 1 This virus can be detected on different surfaces in a contaminated site. 2 Here, we report the stability of SARS-CoV-2 in different environmental conditions. We first measured the stability of SARS-CoV-2 at different temperatures. SARS-CoV-2 in virus transport medium (final concentration ∼6·8 log unit of 50% tissue culture infectious dose [TCID50] per mL) was incubated for up to 14 days and then tested for its infectivity (appendix p 1). The virus is highly stable at 4°C, but sensitive to heat. At 4°C, there was only around a 0·7 log-unit reduction of infectious titre on day 14. With the incubation temperature increased to 70°C, the time for virus inactivation was reduced to 5 mins. We further investigated the stability of this virus on different surfaces. Briefly, a 5 μL droplet of virus culture (∼7·8 log unit of TCID50 per mL) was pipetted on a surface (appendix p 1; ∼cm2 per piece) and left at room temperature (22°C) with a relative humidity of around 65%. The inoculated objects retrieved at desired time-points were immediately soaked with 200 μL of virus transport medium for 30 mins to elute the virus. Therefore, this recovery of virus does not necessarily reflect the potential to pick up the virus from casual contact. No infectious virus could be recovered from printing and tissue papers after a 3-hour incubation, whereas no infectious virus could be detected from treated wood and cloth on day 2. By contrast, SARS-CoV-2 was more stable on smooth surfaces. No infectious virus could be detected from treated smooth surfaces on day 4 (glass and banknote) or day 7 (stainless steel and plastic). Strikingly, a detectable level of infectious virus could still be present on the outer layer of a surgical mask on day 7 (∼0·1% of the original inoculum). Interestingly, a biphasic decay of infectious SARS-CoV-2 could be found in samples recovered from these smooth surfaces (appendix pp 2–7). 39 representative non-infectious samples tested positive by RT-PCR 3 (data not shown), showing that non-infectious viruses could still be recovered by the eluents. We also tested the virucidal effects of disinfectants by adding 15 μL of SARS-CoV-2 culture (∼7·8 log unit of TCID50 per mL) to 135 μL of various disinfectants at working concentration (appendix p 1). With the exception of a 5-min incubation with hand soap, no infectious virus could be detected after a 5-min incubation at room temperature (22°C). Additionally, we also found that SARS-CoV-2 is extremely stable in a wide range of pH values at room temperature (pH 3–10; appendix p 1). Overall, SARS-CoV-2 can be highly stable in a favourable environment, 4 but it is also susceptible to standard disinfection methods.
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            Airborne transmission of SARS-CoV-2: the world should face the reality

            Hand washing and maintaining social distance are the main measures recommended by the World Health Organization (WHO) to avoid contracting COVID-19. Unfortunately, these measured do not prevent infection by inhalation of small droplets exhaled by an infected person that can travel distance of meters or tens of meters in the air and carry their viral content. Science explains the mechanisms of such transport and there is evidence that this is a significant route of infection in indoor environments. Despite this, no countries or authorities consider airborne spread of COVID-19 in their regulations to prevent infections transmission indoors. It is therefore extremely important, that the national authorities acknowledge the reality that the virus spreads through air, and recommend that adequate control measures be implemented to prevent further spread of the SARS-CoV-2 virus, in particularly removal of the virus-laden droplets from indoor air by ventilation.
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              Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing

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                Author and article information

                Journal
                Adv Colloid Interface Sci
                Adv Colloid Interface Sci
                Advances in Colloid and Interface Science
                Elsevier B.V.
                0001-8686
                1873-3727
                29 April 2021
                29 April 2021
                : 102435
                Affiliations
                [a ]Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, HI 96822, United States
                [b ]Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96826, United States
                Author notes
                [* ]Corresponding author at: 2540 Dole St, Holmes Hall 302, Honolulu, HI 96822, United States.
                Article
                S0001-8686(21)00076-2 102435
                10.1016/j.cis.2021.102435
                8084286
                33971389
                6c20be2c-3214-4175-9093-4b085dfc79b9
                © 2021 Elsevier B.V. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 27 April 2021
                Categories
                Historical Perspective

                covid-19,sars-cov-2,mask,particle,filtration,decontamination,bfe, bacterial filtration efficiency,cdc, centers for disease control and prevention,covid-19, coronavirus disease 2019,ecdc, european centre for disease prevention and control,eto, ethylene oxide,fda, food and drug administration,ffr, filtering facepiece respirator,ffp, filtering facepiece,mgb, mass general brigham,mpps, most penetrating particle size,niosh, national institute for occupational safety and health,nnu, national nurses united,pfe, particle filtration efficiency,pm, particulate matter,pp, polypropylene,ppe, personal protective equipment,qnft, quantitative fit test,r0, basic reproduction number,rt, effective reproduction number,rh, relative humidity,rpe, respiratory protective equipment,sars-cov-2, acute respiratory syndrome coronavirus 2,tcid50, fifty-percent tissue culture infectious dose,til, total inward leakage,tpi, threads per inch,un, united nations,uv, ultraviolet,uvc, the uv spectrum with wavelength from 200 to 280 nm,uvgi, ultraviolet germicidal irradiation,vfe, viral filtration efficiency,vhp, vaporized hydrogen peroxide,who, world health organization,δp, differential pressure across a mask or filter material

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