Should you ditch the face masks for N95 or K95 respirators?

Dr. Christopher Udovich, medical director at Silver Cross Hospital in New Lenox, provides some insight

With the rise in the omicron variant, face mask conversation lately has turned from, “Should I wear a face mask?” to “Should I wear an N95 or KN95?”

Some stories in the media suggest the Centers for Disease Control may update its masking guidelines to, possibly, recommend N95s or KN95s.

But N95s and KN95s are not the same as surgical and cloth masks and come with their own benefits and caveats. So Dr. Christopher Udovich, medical director of Silver Cross Hospital in New Lenox, provided some insight on choosing a face mask, while stressing that he is not “a mask expert.”

1) So are N95 and KN95s the best face masks to wear?

“First of all, N95s and KN95s are not face masks,” Udovich said. “They are respirators. And respirators may not be [the] right face covering for everyone.

“They’re a little more uncomfortable and harder to breathe through. Some people won’t be able to tolerate them.”

2) So there is no ideal face mask that everyone should wear?

“The ideal face mask is the one that people can wear comfortably, consistently and correctly,” Udovich said. “It should fit snugly across the face and over the nose and mouth without gaps. Cloth masks should have two layers of breathable fabric and not be made of vinyl.

“Also, relying on just respirators won’t help prevent the spread of COVID-19. People still need to social distance, wash their hands frequently, stay away from public gatherings in the short term and get vaccinated.”

3) Well, then, why should the general public consider wearing N95 or KN95 respirators?

“N95 and KN95 respirators are designed to filter more particles than surgical and cloth masks,” Udovich said.

4) What is the difference between an N95 and KN95 masks?

“Country of origin,” Udovich said.

“N95s are manufactured in the U.S. and certified by the National Institute for Occupational Safety and Health. KN95s are manufactured in China.”

Udovich said the CDC’s main concern is that 60% of KN95s are counterfeit.

The CDC has a list of NIOSH-approved N95 respirators on its website.

5) How do I properly wear an N95 respirator?

“In the hospital setting, staff have their respirators fit-tested to ensure a good seal and proper inhalation,” Udovich said. “So a person in the community must ensure the respirator has a good seal.”

Beards and other facial hair will inhibit that seal, Udovich said. N95s and KN95s are also not recommended for children, he said.

A 2021 peer-reviewed study that compared the efficacy of various masks and respirators by their fit stressed the importance of a proper fit. The study also said a proper fit can be challenging to accomplish even in the health care setting.

“Surgical masks, poorly fit KN95 respirators, and basic fabric face coverings offered similar levels of protection to the wearer,” according to the study.

For prevention of COVID-19, do not wear a respirator with exhalation vents, Udovich said.

“That might be good for the person wearing the mask,” Udovich said. “But it won’t prevent them from giving it [COVID-19] to someone else.”

6) Does the respirator need to be cleaned? Or are respirators disposable?

“That’s a tough question,” said Udovich, who’s hoping the CDC will give guidance to the general public.

He said that, in the hospital setting, N95 respirators are listed as single use. For use in the community, that answer is less straightforward. If a person only wore the N95 for 30 minutes in a story, the respirator might be fine to reuse, he said.

An N95 that looks soiled or dirty should be discarded and replaced, he said.

“If you notice you’re having a hard time breathing, that typically tells me the filters are full,” Udovich said.

7) How do I safely remove and store an N95 or KN95?

“Remove the respirator by the earpieces,” Udovich said. “Do not touch the actual respirator.”

8) Can I double-mask when wearing an N95 or KN95?

Udovich said he has seen people wearing cloth or surgical masks over their N95s. Health care professionals often wear a procedure mask and shield over the N95.

“But it’s unnecessary to wear two N95 respirators,” Udovich said.

9) How long can I safely wear an N95 or KN95?

Udovich said he doesn’t have data on that. N95s don’t inhibit breathing; they filter the air coming in and going out, he said.

10) Is there anyone who should not wear a respirator?

Udovich said people with existing heart or lung conditions – those with heart failure or who have asthma or COPD – should discuss the limitations and benefits of N95s and KN95s with their doctor.