With the Delta variant on the loose, some experts say people should wear better masks

Workers inspect the quality of N95 masks on the production line at United States Mask in Fort Worth, Texas, Feb. 5, 2021.COOPER NEILL/NYT

With indoor mask use returning as the Delta variant spreads across the country, some experts are suggesting people use better masks than the scraps of cloth they used earlier in the coronavirus pandemic.

“The quality of masks is key,” said Dr. Abraar Karan, an infectious diseases fellow at Stanford University who has been an outspoken proponent of using better masks.

He said people, when they are in public indoor spaces, should be wearing N95 masks or masks that are nearly equivalent, or surgical masks with “fitters” designed to make the masks seal more tightly to the face.

He wants the federal government to make high-quality masks “readily accessible, available, and affordable.”

“You should be able to walk down to your grocery store ... and grab these masks off the shelf,” said Karan, formerly an internal medicine physician at Brigham and Women’s Hospital. “They just work that much better than cloth masks. We’ve proven it. We’ve shown it.”

Karan and colleagues have called since last year for Americans to get access to better masks. In January, they proposed a “National Hi-Fi Mask Initiative,” saying that ideally a set of high-filtration masks should be mailed to every American household every month.

The mask page on the website of the US Centers for Disease Control and Prevention still leads off with tips on cloth masks. N95s are discussed at the bottom. The page says N95s should be prioritized for use in health care settings, though as they “become available they can be worn in non-healthcare settings.”

Early this year, as the winter coronavirus surge raged, masking was big news. President Biden’s first executive order asked all Americans to wear masks of their choice for 100 days while the nation’s vaccination campaign gathered steam.

The importance of masks seemed to fade as vaccination levels increased and coronavirus cases fell up to early July. But now the Delta variant is fueling a new surge in cases, hospitalizations, and deaths.

“It’s unfortunate to see us back here,” Karan said. He said it was clear that vaccinations would never be a “silver bullet” that would stop the virus in its tracks, but would need to be part of a multi-layered protection strategy that also included things such as masks and improved ventilation.

N95 masks are considered the gold standard mask, blocking 95 percent of airborne particles. KN95 masks, which are manufactured in China, can be equivalent to N95s in effectiveness, but they have not gone through the federal approval process.

Karan isn’t alone in calling recently for people to switch to better masks.

“I do think we need to upgrade our masks,” Dr. Ezekiel Emanuel, vice provost for global initiatives at the University of Pennsylvania, said in an Aug. 2 media briefing held by the Infectious Diseases Society of America. “We know that ... good masks make a big difference and are very important. N95 masks, which weren’t available last March and April, are readily available now, including ones made in the United States.”

“Surgical masks are very good. They’re not quite as good as N95s,” he said. He also emphasized that people have to wear their masks properly, not under their nose, for example.

Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota., told CNN Wednesday, “We know that face cloth coverings can reduce the amount of virus that you may inhale, but to be fully protected ... you need to have the kind of protection” that comes with masks such as N95s or KN95s.

“It’s a fantastic idea at this point in time to move toward higher-quality masks,” especially if you’re unvaccinated or otherwise vulnerable to severe disease, Chris Cappa, an environmental engineer and professor at the University of California at Davis, told The Washington Post last month.

Former FDA Commissioner Scott Gottlieb suggested Sunday on CBS-TV’s “Face The Nation” that schools should also be considering higher-quality masks, citing the Utah governor’s decision to make available to every school KN95 masks.

Dr. Rick Bright, a virologist who is the former head of the federal Biomedical Advanced Research and Development Agency, said in a tweet Thursday that “effective masking will reduce the spread of virus. N95 and KN95 respirators are the most effective at reducing the spread of this aerosolized virus. We have powerful tools (vaccines, N95, tests). We need to use them.”