Throughout history, infectious diseases have been part and parcel of the human experience.  Ever since the middle ages, we have figured out that some infections have the capacity of passing from person to person.  Medical personnel have made efforts to protect themselves from becoming the next victim to succumb from the disease.  This makes sense from more than a selfish standpoint:

In survival situations, there will be few medically trained individuals to serve a group or community.  The medic does a disservice to their people by becoming the next casualty of a epidemic.  Even before we knew there were such things as viruses and bacteria, efforts to protect the heathcare provider were made.

In medieval times, doctors who ministered to patients suffering from the Bubonic or Pneumonic plague wore masks.  These masks often had herbs in them which were thought to protect the wearer from contagion.  Protective gloves, gowns, and caps made their appearance as well.

18^th Century Plague Doctor’s costume

Around the year 1900, masks began to be used routinely during surgery to prevent micro-organisms residing in medical personnel’s noses and mouths from contaminating the operative field.  A secondary purpose was to protect the wearer from blood spatter and other fluids from the patient.  These were not always used by all members of the surgical team, as you can see below:

Typical Turn of the Century Operating Theater

Surgical Masks in Modern Times

Nowadays, the basic surgical mask hasn’t changed much in general appearance. No doubt, you’ve seen photos of people wearing them in areas where there is an epidemic.  In Asia, especially, it is considered good etiquette and socially responsible to wear them if you have a cold or flu and are going out in public.  Face masks have the added advantage of reminding people to keep their hands away from their nose and mouth, a major source of the spread of infection.

If you will be taking care of your family or survival group in situations where modern medical care is unavailable, you will want a good supply of masks (and gloves) in your medical storage.   Without these items, it will be likely that an infectious disease could affect every member, including yourself.

How Surgical Masks Protect Patients and Doctors

Medical masks are evaluated based, partially, on their ability to serve as a barrier to very small particles (we’re talking fractions of microns) that might contain bacteria or viruses.  These are tested at an air flow rate that approximates human breathing, coughing sneezing.  As well, masks are tested for their ability to tightly fit the average human face.  The most commonly available face masks use ear loops or ties to fix them in place, although adhesive masks are being developed.  Most masks are fabricated of “melt-blown” coated fabric, providing better protection than woven cotton or gauze.

Standard medical masks have a wide range of protection based on fit and barrier quality; 3 ply masks (the most common version) are more “breathable”, as you can imagine; 6 ply masks likely present more of a barrier.

The upgrade to the basic mask is the N95 respirator mask.  N95 Medical Masks are a class of disposable respirators that have at least 95% efficiency against particulates > 0.3 microns in size. These N95 masks protect against many contaminants but are not 100% protective, although N99 masks (99%) and N100 masks (99.7%) are also available.  The N stands for non-oil resistant; there are also R95 (oil resistant) and P95 (oil proof) masks, mostly for industrial and agricultural use.  Many of these masks have a square or round “exhalation valve” in the middle, which helps with breathability. None of these masks, which do not cover the eyes, are protective against gases such as chlorine.  For this, you will need a “gas mask”, subject of a future article.

An n95 mask (or really, any mask) is ineffective if not fitted properly.  For OSHA’s guidelines on fit, click this link:

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=standards&p_id=9780

So what would be a reasonable strategy?  You’ll need both standard and N95 masks as part of your medical supplies.  I would recommend a significant number of each as the masks will be contaminated once worn and must be disposed of.

There are no absolute standards with regards to who wears what in the sick room. I would recommend using the standard surgical masks for those who are ill, to prevent droplets from coughing or sneezing (which can send air droplets several feet) and the N95 masks for the caregivers.  In this fashion, you will give maximum protection to the medical personnel.  Remember, your highest priority is to protect yourself and the healthy members of your group.  Isolate those that might be contagious, have plenty of masks, as well as gloves, aprons, eyeware, and antiseptics, and pay careful attention to every aspect of hygiene. Your survival may depend on it.

Dr. Bones

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