Why copper face masks with slits, vents won’t protect you against COVID-19
If you fancy wearing stylish face masks, chances are you have already tried the metallic or bright-colored ones claiming to be made out of copper and have holes in the chin area.
But the question is, can they truly keep coronavirus at bay?
Medical experts say no.
Earlier this week, Makati Medical Center got some netizens talking after a few of them shared a photo of the hospital’s signage on Facebook that prohibited the use of copper masks, as well as masks with valves, on its premises.
“What’s wrong with copper masks?” others commented.
PhilSTAR L!fe asked MakatiMed Director Dr. Saturnino Javier and, it turns out, the copper mask has holes in the chin area that can promote the spread of coronavirues.
Dr. Javier elaborated this through MakatiMed’s official statement written by Dr. Janice Caoli, MakatiMed department manager for Infection Prevention, and released on Jan. 5.
It said, “MakatiMed earlier released a memo stating that masks with exhalation valves or vents are not recommended to be used in the hospital because these types of masks may not prevent the user from spreading COVID-19 to others. Masks with slits or holes located near the mouth or nose may also allow respiratory droplets to be dispersed in the air.”
“The Infection Prevention and Control Department reiterates to all patients, visitors, healthcare workers, employees, and outsourced service providers that masks or respirators with exhalation valves, vents, slits, or holes are not allowed in the premises of Makati Medical Center,” Dr. Caoli continued. “Individuals wearing masks in the hospital will be required to put on a surgical mask to cover the defect—for your own protection.”
The Philippine College of Physicians affirms MakatiMed's protocol
The Philippine College of Physicians (PCP), an umbrella organization composed of 10,000 internists in the country, expressed support for MakatiMed in a Facebook post uploaded on Jan. 6.
The PCP wrote, "Face mask should cover your face from the bridge of your nose to under the chin. Masks with vents or exhalation valves are not advised because they allow the unfiltered breath to escape the mask.”
PCP president and infectious disease expert Dr. Mario Panaligan discussed this further in an interview with PhilSTAR L!fe on Jan. 7.
He said, "There's a problem in terms of misconception or misunderstanding of how a mask must be used and how it can be useful. Akala kasi ng iba, kapag merong mask, protected ka na agad. Definitely, kailangan naka-fit rin iyon, there should be no leak, and should not be placed above the nose, ginagamit siya na parang headband, or on the chin. Kasi dapat shield 'yung nose mo, shield rin and mouth mo so you won't be able to expel out 'yung mga secretions mo, saliva when you talk, and of course, the air.”
"That shouldn't happen to people with respiratory infections. Kasi ang misconception, you are protected from the mask when in fact, you should protect others from you. That's basically the problem," he added.
Dr. Panaligan stressed that masks with ventilators are specifically designed for hospital use—unlike those being marketed elsewhere today.
"In the advertisements sinasabi, it's for you to get more air. Lalong walang use and mask mo nun kasi ilalabas mo rin, e. It would actually be a passageway for air to go in and go out," he said. "'The vent is mainly to make sure that whatever you expel won't actually go out. It should be 'yung moisture, the air na galing sayo hindi lalabas."
"Pang-hospital lang 'yung special masks with vents or ventilators. The masks that we use while taking care of hospitalized patients with moderate, severe or critical COVID-19, iyon 'yung purpose nun. It's really to protect other people from you,” he continued. "So hindi siya dapat ginagamit sa labas ng hospital.”
Neither are copper masks with vents exempted from this health standard, the PCP president said.
“So ‘yung vent na nakalagay sa copper mask, kelangan ‘yung tama ‘yung nakalagay,” he continued. “Kapag sinabing may vent sa non-medical or non-special mask, it may not be the purpose really. But rather, ‘yung advertisement na makakatulong na makahinga ka—mail na ‘yun. Hindi rin ‘yun makakatulong. So therefore, kung gagamit ka nun, you still have to adhere to the other measures.”
Dr. Panaligan added, "Iyon 'yung gusto namin i-correct kasi nakaka-cause ng misbelief 'yun na 'Ay, lalo akong makakahinga kasi may vent' pero meron 'yung leak, iyon 'yung nakakatakot doon.”
Kapag sinabing may vent sa non-medical or non-special mask, it may not be the purpose really. But rather, ‘yung advertisement na makakatulong na makahinga ka—mail na ‘yun.
It is for these reasons that the PCP is backing up MakatiMed’s stance on this matter.
“So it aligns with what the Makati Medical Center released,” Dr. Panaligan told PhilSTAR L!fe. “Noong nakita kasi rin namin ‘yun, tama naman talaga na we should actually emphasize na COVID-19 is mainly transmitted by the droplets—the particles na galing sa laway mo or phlegm kung meron ka. So ‘yun mape-prevent ng mask mo ‘yung expulsion or transmission nun. So yun talaga yung purpose ng mask.”
Dr. Anthony Leachon, past president of PCP and health reform advocate, seconded Dr. Panaligan and MakatiMed’s viewpoint in a separate interview with PhilSTAR L!fe that day.
“It has become a fad,” Dr. Leachon said, referring to copper masks with slits or vents. “Kasi it has become entrepreneurial. At this time na meron tayong UK variant, we must ensure that the established and well-studied protocols must be followed and that includes the face mask. Kasi kung we will deviate from the well-established protective gear, we might be risking the health of a lot of people. Kaya we really made a solid stand on that.”
Like many of us, the former National Task Force on COVID-19 adviser admitted that he tried using the copper mask sold almost everywhere today. But that only happened once.
“Ako mismo, I feel I'm not protected,” he said. “Kasi mayroong twenty to thirty gauze na ipapalit mo doon sa mask every day. Pinapalit niya ‘yung gauze and mine-maintain niya ‘yung [outer] copper mask. Ang problem ko, if you don't clean up the covering, e, hindi ka pa rin protected even if you have the new gauze na. That's the main reason hindi ko na ginamit.”
“Number two, copper pa rin 'yun, e, kung ma-inhale ko? It's a metal. The effect of copper in your body, hindi mo sigurado yan,” he added.
Kasi kung we will deviate from the well-established protective gear, we might be risking the health of a lot of people. Kaya we really made a solid stand on that.
Dr. Leachon underlined that unlike surgical masks, today’s copper masks are not yet recognized by the healthcare industry.
“Number three, if it's really effective, bakit hindi siya ginagamit sa operating room? Ang tagal ko nang doktor, 35 years na, surgical masks pa rin ang ginagamit,” the health reform advocate pointed out.
“In the operating room, which is the cleanest part of the hospital, ang ginagamit ay surgical, walang gumagamit ng copper mask. So ibig sabihin, napagaralan na ng maraming doctor.”
The Philippine Society for Microbiology and Infectious Diseases suggests likewise
In a Facebook post uploaded on Jan. 5, the Philippine Society for Microbiology and Infectious Diseases (PSMID) also called an end to the use of masks with slits or valves.
Dr. Edwin Pasumbal, infectious disease expert and member of PSMID, elaborated on this during his interview with PhilSTAR L!fe on Jan. 7.
He said, "Ang issue lang natin with the commercially available masks that were produced during the COVID-19 pandemic... why we're not recommending it is that the currently available copper mask, meron silang slit sa ilalim and that's not allowed and 'yung iba, meron silang valve na attached. And that is not recommended by the CDC (United States Center for Disease Control and Prevention) kasi it defeats the filtering purpose of the mask. So that's the main reason. It's because of the presence of the slit and the valves why it's not recommended. In some hospitals."
Dr. Pasumbal revealed that aside from MakatiMed, other hospitals in the country, including St. Luke's Medical Center, are stopping people from using such masks.
He continued, "St. Luke's recently came out with their advisory, if you're going to wear this mask or those with valves—not necessarily copper mask—the recommendation is number one, to change it to an N95 or a plain surgical mask. But if not available, they have no choice but put a surgical face mask on top of the copper mask or any mask with valve. That is the recommendation."
Can copper kill coronavirus?
"Kung meron namang available na copper mask na walang valves, kung wala namang valves o wala namang slits, then it's safe to use. 'Yun lang and issue dyan—the presence of the slits and the valves," Dr. Pasumbal said.
Scientists have previously proven that copper can limit the spread of certain viruses, including E. coli, salmonella, influenza, and SARS CoV-2 or the virus that causes COVID-19.
"Actually, copper masks have been around as early as 2010," Dr. Pasumbal told PhilSTAR L!fe. "The current term is copper-impregnated mask kasi meron siyang biocidal property. It can actually kill the virus. So even before the COVID pandemic, ginagamit na 'yan for protection against flu and other viral infection."
Dr. Panaligan attested to that claim, as he said, "Si copper, proven naman talaga. Meron siyang microdecidal or biocidal properties that's actually proven."
The New York Times also reported that the New England Journal of Medicine discovered that under controlled conditions, coronavirus couldn’t last more than a few hours on copper surfaces, compared with a couple of days on stainless steel or plastic.
And copper masks don't have to be made out of 100 percent copper to be fully effective, said Dr. Pasumbal.
"It doesn't have to be a hundred percent. It depends na din sa manufacturer niyan, but it doesn't have to be a hundred percent copper," Dr. Pasumbal clarified.
Kung meron namang available na copper mask na walang valves, kung wala namang valves o wala namang slits, then it's safe to use. 'Yun lang and issue dyan—the presence of the slits and the valves."
The PCP noted, though, that just like any other mask, the ones infused with copper could experience a lot of wear and tear.
Dr. Panaligan explained to PhilSTAR L!fe, "Pero syempre, hindi naman 'yan forever na pagnaka-copper mask ka, protected ka na. Kasi tandaan mo, 'yung tenuity ng mask, nasisira rin 'yan, nagkakaroon ng leak. Pangalawa, naco-consume 'yun, e, paghindi mo pinalitan or hindi mo nilinis, that could actually facilitate the acquisition or transmission of the virus."
"But as I've said, copper has been proven to have this capability to control the viruses including the flu, the SARS CoV 2, and of course, different bacteria like yung E. coli, yung common cause ng infection especially as urine."
That is not the case, though, for US-based microbiologists Karrera Djoko, who told The New York Times that copper could also increase the chances of people being infected with coronavirus.
Dr. Djoko said that when copper physically contacts a germ-like coronavirus, it can release reactive ions that puncture the bug’s exterior. As the ions penetrate the bug’s innards, they also spread those same germs on the copper.
Not all copper masks are the same
Have many copper masks at home? Don't throw them out just yet because not all copper masks with holes are the same.
Some offer enclosed inner fabrics that patch up the holes in the chin area and stop the spread of saliva droplets when you're wearing them. These inner fabrics, according to Kino Obach, owner of The Copper collection that distributes MagiCopper masks, are fully stitched "without air channels or holes for full-coverage protection."
To make the most of these copper masks' functionality, Obach suggests "washing the special inner fabrics with any type of soap or detergent daily depending on use. The outer mask, on the other hand, can simply be wiped with cloth and water to eliminate dirt."
Editor's note: This article was updated to include the medical experts' advice on wearing copper-infused masks with slits, vents, and valves, and not copper masks in general.
Banner photos from Shopee and Makati Medical Center.