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Judy Newberger, RN

COVID-19 Update - "The 3 Ws" and Masks

The last Atrium health education table on March 8th included a display educating the parish on a novel virus which would, soon after, be known as the cause of a pandemic.


Eight months later, we are all bombarded daily with “The 3 Ws” –

• Wash hands frequently for at least 20 seconds.

• Watch your distance - at least 6 feet distance from others.

• Wear a mask when outside of your home.


Social media not only has posts from reputable sites on the why, who, where, when, what, and how of wearing masks and social distancing; they also include posts of myths, misconceptions, and feelings mixed with the facts. Plus, it is normal to be confused when true experts’ recommendations change and sometimes seem contrary to what they said previously.


Science is not static. Recommendations change as stronger research and/or larger numbers in studies provide new data that leads to new conclusions.


Science uses the word “may cause," because rarely is something 100% true for 100% of the population.


CURRENT RECOMMENDATIONS ON MASK USE


Why?

Masks provide a simple barrier to keep respiratory droplets from reaching others when you cough, sneeze, talk, or breathe. These droplets may contain coronavirus even if you have no symptoms. Recent studies show that correct mask wearing over the mouth and nose also may reduce the chance of acquiring the virus.


Who?

Everyone over the age of 2.


Where & When?

In public spaces and when around people who do not live in their household.


What?

  • Non-medical disposable masks

  • Properly fitting reusable masks made with:

Breathable cotton

Tightly woven fabrics

Masks with two or three layers

Masks with inner filter pockets


Who should not? *

  • Children under 2

  • Anyone incapacitated, unconscious, or with sensory, cognitive, behavioral issues who are unable to wear a mask properly, cannot tolerate or cannot remove a mask.

(* NOTE! People with asthma and most medical conditions can and should wear masks. Those having trouble breathing should discuss their concerns with their healthcare provider.)


How?

  • Wash or sanitize your hands for at least 20 seconds before AND after putting on mask.

  • Put mask over your nose and chin.

  • Fit snugly over sides of face.

  • Use straps but avoid touching front of mask to adjust mask.

  • If you touch your face to adjust mask, wash hands again or use hand sanitizer.

  • Wash reusable or change disposable mask daily to maximize effective use.


ALTERNATIVES


Masks with Exhalation Valves or Vents – May allow virus to escape. Do not wear!


Gaiters – Not as effective but a gaiter with two layers partially protects.


Face Shields – May be worn with a mask to reduce transmission through eyes if close contact is unavoidable. Worn alone, they allow droplets to enter through the air around its edge. Research is lacking on effectiveness against coronavirus in general public use. It does not seem to reduce transmission. CDC recommends against shield use as a substitute for a mask. Only use if an individual cannot wear a mask for indications given above or for those who work with the hearing impaired community.


Bandanas and Scarves – Are not as effective as masks. Two-ply may offer some protection but they leak respiratory droplets through the top and bottom.


N95 Respirators and Medical Quality Surgical Masks – Most effective but should only be used by healthcare professionals, first responders, and in a hospital setting.


OXYGEN AND CARBON DIOXIDE LEVELS


Oxygen Levels – Studies have shown no decrease in oxygen levels even in older adults with medical issues. Some studies have been done with N95 masks which keep out more air than commonly used community masks. Plus, healthcare workers work 12 hour shifts and even longer wearing masks.


Carbon Dioxide Levels – Masks are designed to trap viral particles which are much larger than a carbon dioxide molecule. Masks, even N95 masks, cannot hold all carbon dioxide particles – the particles either leak through the mask or around its edge.


DISCOMFORT


The most common reason people have discomfort and trouble breathing while wearing a mask is simply from not being used to wearing one. Some notice breathlessness, heart racing, even sweating, nausea, and a feeling like passing out.


“The sensation of having something over a person’s face makes some anxious or uncomfortable” (Christopher Ewing, MD). Breathing that is usually unconscious and spontaneous, then becomes subconsciously influenced by the mind. Suddenly, we are thinking about our breathing. If our glasses fog up, we may subconsciously breathe shallower or not exhale as much as we should, breathing from the chest rather than abdomen. The resulting hyperventilation (breathing too fast) can cause carbon dioxide to build up and that can cause the anxious feeling of not being able to breathe. This can be corrected or prevented.


Breathing Better with a Mask

• Try different mask types. With nose pinchers if you wear eyeglasses.

• Purchase and use eyeglass defogger if needed.

• Wear a mask for short periods of time, gradually increasing the time from 15 minutes to a couple hours and longer.

• Wear a mask at home while watching TV, playing video games or some other distractive activity.

• Reset irregular breathing by using your diaphragm. Use abdominal breathing.

• “Box Breathing” Exercise:

4 seconds - Breathe in

4 seconds - Hold breath

4 seconds – Breathe out

4 seconds – Hold your breath

Repeat


Getting used to wearing a mask is similar to adjusting to contact lenses or bifocals. It takes practice and time for some, while others have no problem adjusting from the beginning. Practice, practice!


As Christians, we are to serve Christ by serving each other. There is nothing better we can do to serve others during this pandemic than by doing what we can to reduce the likelihood of unknowingly spreading this disease.


Love your neighbor!

• Wash your hands

• Watch your distance

• Wear a mask


Judy Newberger RN, CNM (ret.)

Faith-Community Nurse

St. John the Baptist Catholic Church

717-235-2156 ext. 214

jnewberger@sjbnf.org



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