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*** Update – the UK Government now recommends face coverings are worn where you cannot guarantee staying 2 metres apart from other people, such as in supermarkets or at work. It is mandatory in Scotland. Which? consumer information has this good article summing it up.

The BVA has also issued advice regarding face coverings for veterinary professionals and there is additional advice for Scotland:

“The wearing of a face covering is optional, but veterinary practices may want to consider the following:

  • asking staff to wear cloth face coverings when not using surgical masks for specific tasks (eg surgery and chemotherapy) – this helps to model good behaviour and is a reminder that we are not working as normal
  • asking clients to wear cloth face coverings if it is essential that they enter the practice – this should be discussed during the triage and appointment booking process.”

I am now making masks by custom order only as I have been overwhelmed by requests. Orders now join a waiting list so I can give you an accurate idea of when your order will be ready. This is generally only a week or so, unless a large order of many different masks or a custom design. I also keep a few extra masks that are ready immediately, if you need something ASAP and are not so particular about fabric choices. I take larger orders for teams of vets and can do custom fabrics and designs and embroider initials so you know who’s mask is who’s!

Please message me through my Etsy shop or email me at sarah.keir(at)yahoo.com.

Keep safe and well! ***

Fabric Masks and Face Coverings

As I unexpectedly have some free time at present, I am making myself useful by diversifying into selling my crafts! All my locum and freelance work has disappeared and I fall into the category of getting diddly-squat from the Government. Rather than getting down about this, I am finding ways to support myself until such time as locum vets are needed again and while waiting to see if other job opportunities come to fruition. Currently I am concentrating on making face masks so that we can free up vital PPE for the NHS and help to keep ourselves safe. I have put some information below about the efficacy of fabric masks and how to wear and use one (see FAQ at the bottom of the page). I am also making some solid moisturising lotion bars as with all this hand washing, I am sure your hands are getting very dried and cracked as mine definitely are!

Please see my Etsy shop at SarahTheVetShop here. I am getting new fabrics all the time and will put them in the shop once they are quality checked and washed so please check back frequently to see what is available. I am also open for discussing custom orders or suggestions for colours or fabrics.

I am making masks as fast as I can – they take about an hour to make each one so please bear with me! I also wash all the fabric first to ensure it is as clean as possible and pre-shrunk. The Royal Mail is working very hard to deliver post but there it is a little slower then usual so please bear with as they get your masks delivered!

Please send me photos of you wearing your masks and I will pop them on here so we can spread a little brightly coloured cheer around! Email them to sarah@sarahthevet.com

Do Fabric Face Masks Do Anything?

I am sure this question has gone through your mind, as it has done mine too. On balance, I would rather do something that has some positive effect rather than nothing at all and the evidence that I can find does show that fabric face masks are better than nothing and in particular they prevent transmission from the wearer to other people. However, fabric face masks are not N95 masks or certified PPE. What they do serve is to remind us not to touch our faces (for me this is like being in the operating theatre with gloves, gown and face mask = don’t touch anything to keep sterility). They are designed to be used when N95 or respirator masks or formal surgical masks are not required or are not available. I think we are at that situation NOW! There are more and more reports of countries (Austria) and cities (New York and Los Angeles) requesting or requiring people to wear masks or at least cover their mouth and nose when going outside.

The masks I make will not stop you catching COVID-19 or any other respiratory virus but it is likely it will REDUCE the risk of you potentially spreading it unwittingly by containing coughs and sneezes (it is unknown how many carry the virus without symptoms but it is thought to be a high percertage), and also reducing the inhalation of large airborne droplets and reducing the amount that you touch your face which are the main ways that COVID-19 is spread and caught. This is not an item of PPE or medical equipment. They are meant to help block large-particle droplets, splashes, sprays or splatter that may contain germs (viruses and bacteria), keeping it from reaching your mouth and nose. As vets we need to reduce the amount of human-grade protective equipment we use to free this up for those that really need it in the NHS and, as vets, we have a much lower risk of giving anything to our patients or catching something from them. I recommend you wear this mask with eye protection such as safety specs or goggles like what we use for dental treatments (I use my jewellery making safety specs – that is what is on the moai model) or face shields if you can make or buy them.

Please see my Etsy shop at SarahTheVetShop here.

Evidence?

*** Some very new research published in the USA on the 24th April. This research shows that cotton performs better at higher weave densities (i.e., thread count) and can make a significant difference in filtration efficiencies. The studies also imply that gaps (as caused by an improper fit of the mask) can result in over a 60% decrease in the filtration efficiency, implying the need for future cloth mask design studies to take into account issues of “fit” and leakage, while allowing the exhaled air to vent efficiently. It is thought that the tightly woven cotton is an effective mechanical barrier, while chiffon and silk become electrically charged easily, forming an electrostatic barrier. Flannel is almost as good, which is what I use to line my masks. The combination works better than trying to double up using multiple layers of the same form of protection. This is great news – it is likely that my masks will offer some protect because they use high thread count cotton outer and a flannel lining with a good fit from the shape and nose piece. I am awaiting some chiffon in the post to experiment with sewing it, even if it is used as a filter. ****

Emerging evidence shows that many people spread coronavirus when they are asymptomatic leading to many places around the world encouraging the wide spread use of any kind of face covering. Have a look at this website that is part of an international campaign and here is an analysis published in The British Medical Journal on the 9th April 2020 calling on the take up the precautionary principle i.e. “there is a moral argument that the public should be given the opportunity to change their behavior in line with the precautionary principle, even when direct experimental evidence for benefit is not clear cut”. We use this principle in many areas of our lives prior to this pandemic so should we not consider it now.

The problem is that most research on the use of face masks has focused on protecting the wearing from getting something (in this case a virus) rather than protecting the wider population from excreters of the virus who are often asymptomatic i.e. transmission. These tests often are using fine sprays directed at masks and testing the air the face side of the mask – not real world scenarios. We know in these circumstances that respirators or N95 masks are needed to give high protection but these need to be fitted for the individual. Surgical masks give some protection but they still don’t stop all viruses getting through. This is a very good summary from Standford Medical. There is good evidence that tightly woven cotton fabric (like a pillowcase) was pretty good and would capture 61-69% of 1-micron particles, which is smaller than what we produce when we cough or sneeze.

Many hospitals around the world – Canada, USA, Belgium – are asking people to make them fabric masks. These are not for use by frontline healthcare professionals, but to put on people recovering from COVID-19 to try to reduce the amount of virus they spread around – for approved visitors and discharged patients – and also to reduce the transmission of COVID-19 from asymptomatic carriers to others.

Emerging Infectious Diseases journal article on fabric masks in the H1N1 epidemic

Research paper in the Disaster Medicine and Public Health Preparedness journal, published by Cambridge University Press, titled ‘Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic?’

Journal paper in ‘Disaster Medicine Public Health Preparation’ from 2013

FAQ

Why are your masks more expensive than others on Etsy?

I cannot comment on the quality or fit of other masks being sold. What I can tell you about my masks: they are made of quality fabrics (and these are more costly); the edges are over-sewn to give more shape and structure to the mask and more durability especially if needing washed frequently; I use quality elastics that are wider than a lot of elastics I have seen being used and are therefore more comfortable and longer lasting; I use jewellery grade copper wire for the nose as these won’t rust like steel wires. For fit, I have tested several designs and this design seems to fit the most number of people best and is comfortable to wear for extended periods of time. I do not sew the elastic loops or tape ties into the mask so if you find you don’t like them, you could remove them and change to ties such as ribbon or if the elastic stretches over time, it can be replaced without damaging the mask. I also have an extra stage of sewing to allow a filter to be fitted in the mask if wished, but the masks look great and wear fine without a filter too. The costs of the materials are increasing all the time now, for example elastic and cotton tape is now between four and ten times the price it was a month ago.

It takes me about an hour to make each mask. Then time is needed to package and post – the queue at the post office is really long now as they are only open for 3 hours each day!

Please see my Etsy shop at SarahTheVetShop here.

Showing fit around the face.

You sell masks with different linings, how do these differ?

Some masks are lined with very soft cotton flannel (the type used for babies bedding etc) and some masks are lined in high thread count quality cotton. This is purely personal preference. Take a closer look at the listing if you need to know if it is lined in flannel or cotton. I am making more masks with cotton lining now as the weather has changed to be a warm summer!

I don’t know if I want tape ties or elastic ear loops, what should I choose?

Tape ties are fiddlier to put on than elastic ear loops but they are more comfortable to wear for longer periods of time. The biggest risk for catching the virus is putting on and taking off your mask so the more times you do this then the bigger risk. I recommend if you are going to wear your mask to pop to the shops every few days then elastic ear loops will be easier; if you need to wear the mask for several hours at a time then tape ties will be more comfortable. Tape ties are machine washable (see below about washing of my masks), but I recommend elastic ear loop masks are hand washed as the elastic will degrade over time in a washing machine though you can wash them in a washing machine on a delicate cycle.

Please see my Etsy shop at SarahTheVetShop here.

What are the difference in the sizes?

The regular masks fit ladies and teenagers and small faces men – I have feedback that this size is fine for the fuller faced lady too! The larger size fits men with large or fuller faces better.

Remember, a mask needs to fit snugly to the face to work so if it is too big it won’t work! You need to breath through the fabric and not around the edges. A full-face beard will interfere with mask fit – NHS staff have been shaving their beards to get better fit for masks.

Filter suggestions

My masks do not have to be worn with a filter. I had some people asking for filter pockets so have altered the design so you can add a filter if you wish.

It is harder to find evidence about what filters to use. A filter layer of dense non-woven material may improve the efficacy of the mask. The best filter would be a surgical mask and putting it inside the fabric mask will help you look less like a zombie when you do your essential shopping. Suggested materials include paper surgical drapes, pack wrap paper (the paper that wraps ready sterilised gowns and surgical kits), melt-blown non-woven fabric, vacuum cleaner bag paper ( NOT HEPA filters as they contain fibre-glass), non-woven sewing interfacing or even hand towels or tissues. You can buy some mask filters on Amazon, but I don’t know how they work in the real work. Change the filter every time you use the mask and wash the mask too.

The Cambridge University study made an important point about the role of breathability and comfort, saying, “If respiratory protection is not capable of accommodating the breathing demands of the wearer, then the device will impose an extra breathing load on the wearer, which is especially impracticable for people with breathing difficulties. Furthermore, the extra breathing load may induce leakage owing to the increased negative pressure in the face mask.” A mask that a person cannot breathe through is ineffective and dangerous. So we must look at both filtration effectiveness and breathability when determining whether a filter material is appropriate for a face mask. I have not tested any filter materials or looked into how effective they are so I leave this choice up to you.

How do I fit my mask?

Firstly, wash your hands! Every time you put your mask on and take it off, you need to wash your hands! Avoid touching the front of the mask when you are wearing it and when you take it off. Wash, wash, wash!

World Health Organisation (WHO) recommendations, including some great posters on how to put on and take off masks. Basically wash your hands before putting a mask on, do not touch the front of the mask once it is on and wash your hands before and after removing the mask.

For ear loop masks, pop the ear loops over your ears and gently squeeze the wire piece over your nose so it fits snuggly. If you find the ear loops are too tight then wrinkle the fabric like this photo. This is the advantage of my masks – the elastic is not sewn into the masks to allow the fabric to slide over the elastic to give a customised fit!

For tape tie masks, pop the mask over nose and mouth and gently squeeze the wire nose piece so it fits snugly. Wrinkle the fabric at the sides of the mask so it fits closer to your head when the ties are tight. Tie the tape ties with one over the top of your head and one around the back. Like this:

I find a mask uncomfortable and hot to wear, help!

As a vet I wear masks everyday, for surgery and other protection. But for people that are not used to wearing masks frequently they do feel strange, even claustrophobic. For a mask to filter the air, it needs to be a snug fit on your face so you will need more effort to breathe as you are forcing air through the mask as you breathe in and out. If the air whistles around the mask then it is not doing its job! The fabric of the mask should move in and out a little as you breathe in and out. And therefore your breath does feel warmer and moister than usual. It also can steam up glasses! It you find that your glasses steam up all the time then try some paper tape to stick the mask closer to your face under your eyes only – this is what surgeons do!

I have also started to make a second design of mask which had more room around the nose and mouth so feels less claustrophobic, but is also well fitting around the edges of the mask. Here it is:

Please see my Etsy shop at SarahTheVetShop here.

How do I wash my mask?

The COVID-19 virus in enclosed in a lipid (i.e. fat) covering which is good news – it is easily destroyed by simple soap! Therefore washing your mask does not need to be done in hot water (I recommend no hotter than 40C to preserve the fabrics and elastic) and all you need is some kind of soap (washing detergent, washing-up liquid, hand soap etc). You don’t need high temperatures or strong detergents to kill the virus!

I recommend hand washing the elastic loop masks as elastic degrades in the washing machine, though if you don’t need to wear the mask frequently and you are not worried about it lasting for years then you could wash it in the machine on a delicate cycle. Hand wash, don’t wring but roll up in a clean towel to remove most of the moisture then allow to finish drying naturally. Don’t tumble dry.

For tape tie masks, you can wash them in a machine and I recommend you wash them inside a lingerie bag or pillowcase. The reason for this is to protect the fabric and also to stop the tape ties getting tangled up! Hand washing the mask will be kinder to the fabrics so it should last longer. Do not tumble dry but allow to finish drying naturally.

Please see my Etsy shop at SarahTheVetShop here.

Do you take custom orders?

Yes! Please contact me at sarah@sarahthevet.com to discuss your requirements! Here are a couple of pictures of custom designs:

Please see my Etsy shop at SarahTheVetShop here.