Sustainable masks & face coverings for 2022 & beyond

My personal evaluation of three consumer grade elastomeric respirators is available further down in this post: Breathe99 B2, FLO Mask, and ZShield Reveal.3 brands of reusable face mask: B2, Reveal, FLO

As of July 2022, many people claim to be “over COVID;” I’m not one of them. I continue to mask regularly. I cover my face to protect a high risk member of my household, and because I have enough uncomfortable health issues of my own already. The specter of long COVID looms large enough to make indoor masking my preference.

Long COVID is most common in middle aged people, affecting as many as one in four recovered patients according to a Nature news feature. The CDC gives me better odds than 25% in their Data for Long COVID section, but, the fact is, no one yet knows the true prevalence of the condition.

Long term, I see no reason to ever stop masking in crowded conditions such as boarding a flight or on mass transit, though my specific level of vigilance will probably vary as this pandemic wanes and flu season comes and goes.Disposable surgical mask

The particular genesis of today’s post was a New York Times article by Andrew Jacobs published July 3, 2022. It’s worth reading, but the gist is that American hospitals should have learned the supply chain lesson of the COVID-19 pandemic and switched to elastomeric respirators for essential healthcare workers by now.

Elastomeric respirators are reusable face coverings using replaceable filter elements that work as well as disposable N95s to block the flow of germs. Many are domestically produced, to boot, in marked contrast to the largely imported supply of disposable masks.

Widespread adoption of elastomeric respirators would solve the problem of being dependent upon a hostile foreign nation for vital supplies while offering equal or better protection to each wearer with a better fit and simultaneously creating less waste.

Win-win-win.Merriam-Webster online dictionary defines elastomer as a noun, "any of various elastic substances resembing rubber"

The “elastomeric” part of the elastomeric respirator just means the body of the filtering face mask in question is stretchy or otherwise like rubber.

If the NYT article is to be believed, elastomeric respirators are often judged more comfortable by the wearer than N95s. Disposable filters are still required, but they might require only annual replacement for a few dollars, while the main body of the device—composed of washable silicone—should last a decade at a one time cost of $15-40 each.

For about two thirds of the money spent by the Trump administration attempting to sterilize and re-use N95s, we could have outfitted each of the nation’s 18 million health care workers with an elastomeric respirator according to Nicolas Smit as quoted in Jacobs’ article.Pile of money

Or, to harp on the affordability point from a different angle, a paper published in the Journal of the American College of Surgeons showed: “Outfitting… workers [with elastomeric respirators] was one-tenth as expensive than supplying them with disposable N95s. A separate study found that after one year, the filters were still 99 percent effective.”

And, given the chance to switch back to N95s after the study period in question, none of the employees opted to do so. I take that to mean those healthcare workers found the alternative masks easier to wear or use.

Toward the end of the New York Times piece was a mention of just one particular small business that’s giving up in the face of the healthcare system’s irrational insistence on sticking with disposable, imported masks. Breathe99—whose elastomeric respirator made the cover of Time magazine in 2020 as an innovation prize-winner—is winding down operations at the company’s Minnesota plant.

I followed the link, and found that I could purchase Breathe99’s B2 mask at retail as of early July 2022. Since I still see daily death reports in my newspaper, I remain in the market for comfortable, effective face coverings. I decided to resume exploration of better Personal Protective Equipment (P.P.E.), hoping I can reduce waste while staying safe.

I don’t buy disposable water bottles or accept single use plastic cutlery when I get takeout food, so why should I continue to rely upon paper face masks when more comfortable, equally effective alternatives exist?

One caveat: there are officially approved elastomeric respirators for clinical use, but consumer grade options are unlikely to be officially NIOSH approved. Whether this is due to pandemic backlogs or if it is just a regulatory grey area, I’m not informed enough to say. Just be aware that we still have no official designation for effective, FDA-approved consumer grade face coverings.

Now that mask mandates have ended and masking is a voluntary, personal choice in most settings, the up side to all of that reckless abandon is that no one is likely to complain about any specific face covering I acquire or wear. There should be no push back to the lack of an official protection rating for any mask I select.

On the down side, I’m left having to hope these products actually work as designed, and as represented by their manufacturers. I’m “doing my own research” here because I have no choice if I want a comfortable, well-fitting, effective face covering. I do go all the way to published papers from scientific journals and material spec sheets whenever possible.

For example, here’s a USA Today fact checking story about why filter media with a physical pore size of around 0.3 micron can be quite efficient at stopping SARS-CoV-2 viral particles which are themselves closer to 0.1 micron.

One clear takeaway of the past couple of years is that any mask offers better protection from airborne viruses than a bare face does. I do feel confident that I won’t end up worse off than I would be wearing a cloth mask or an ill-fitting surgical one when I don a tight-sealing face covering utilizing an effective filter medium at the point(s) where all my breath enters or exits the device.

The author wearing an improvised home-made face covering in 2020

This improvised face covering was my first attempt at masking when the idea was introduced to the general public in 2020. This loose, single layer of fabric is obviously not protective in the way a fitted non-woven medical mask would be, but I crafted it for passing strangers on walks around my neighborhood, so, in hindsight, I wasn’t at high risk when I wore it.

I will compare and contrast three intriguing designs that I’ve purchased at retail and tested for myself for the reader’s convenience. Because these elastomeric products are relatively expensive—from $60 to 90 per starter kit—I hope my comparison will help others pick a useful style.

Because of the note of doom sounded by the NYT article that sent me down this path, I advise anyone picking up one of these expensive face coverings to stock up on specialized, custom fit filters while they are still available. We as a society seem to have learned very little from the deprivations and death wrought by COVID-19. Even top quality, well designed products may be dropped from the market if their makers go out of business.

I ordered three different face coverings direct via their manufacturer’s web sites, paying the stated retail price. Here’s the list including the July 2022 list price:

  1. B2 mask by Breathe99 as referenced in the NYT article ($59.99)
  2. FLO Mask for adults or children though I’m only testing the adult version ($89.99)
  3. ZShield Reveal rigid mask which I pre-ordered and got in 2021 ($89.99)

Continue reading

Dip a COVID-cautious toe in cruise waters

We maintain a COVID-cautious* household as the third pandemic summer waxes. Where one member of our family is at high risk, we all choose to modify our daily behaviors to continue to protect him.

This is a cost of multi-generational living, though I find the personal and familial benefits of sharing our home with an elder abundant and easily justified. Since we can afford all the masks and testing we need, expending this trivial effort is well worth it. That’s the calculus in our home.Disposable surgical mask

Given our status, then, as “more careful than most,” it may surprise some that we plan to embark on a cruise with our teens in a little more than a month. Cruising, after all, gave the world its first widely reported COVID-19 super-spreader event.

Read a CDC research paper on the epidemiology of the Diamond Princess outbreak in February 2020 here.Cruise line booking page headlined 37 days before you leave with photos of Icelandic ports

There’s no doubt that the closed environment of a cruise ship offers a unique opportunity for certain germs to infect a captive audience of susceptible passengers. Many minds will leap immediately to norovirus. In truth, however, norovirus is common everywhere, but an outbreak is much more noticeable when a group of thousands travels en masse for seven or more days and management is required to track cases on board.

Similarly, though COVID-19 is definitively joining current passengers on cruise ships—in spite of requirements for vaccination and pre-embarkation testing—there is little evidence that the virus passes between personal staterooms via HVAC or other means. Actual contact tracing of ship-acquired infections, as on land, suggests spread directly from infected person to uninfected person.2012 Carnival cruise Saint John NB Canada - 3

The greater risk on a cruise comes from queuing to board or partake in activities, eating or drinking in common facilities, or from socializing with other guests. More bodies in close proximity invites more infections. It’s math, not a magical zone of infection brought on by taking a ship out to sea.

Why, then, if we remain vigilant and siloed on land, is my family setting sail?

Like many, the pandemic disrupted our travel plans in 2020. For us, the result was a Future Cruise Credit (a.k.a., an F.C.C.). Cruise Critic defines Future Cruise Credits here.

We could have requested a cash refund when COVID-19 kept us from our 2020 voyage between Copenhagen and Boston. Instead, we opted to gamble on the future solvency of Holland America Line (HAL) and took the F.C.C. instead. Part of my personal rationale was the simple desire to see HAL survive the economic hit of the sudden shutdown.

The major down side to any credit like this is the set of contingencies for spending it. Unless we wanted to argue over the details of the F.C.C. we’d accepted, we had to book a cruise before the end of 2022.Pile of money

Here’s the key to why my family is cruising this summer: we’re not all going. While our 2020 trip would have included a grandparent, our 2022 party consists only of parents and children. All of us are vaccinated, boosted, and at statistically low risk of COVID-19 complications if infected. Our high risk loved ones are not inclined to sail at this time.

For those of us embarking on a pandemic-era Holland America Line cruise, we are opting in based upon a few important understandings:

  • We realize that we will be taking a greater risk of catching COVID-19 than we do at home, but we have decided that this risk is worth the benefit of a relaxing vacation together with the reward of a chance to visit foreign destinations long on our wish list(s).
  • We prefer the risk of being cruise ship passengers over that of unmasked air travel for the summer of 2022, especially given recent frequent flight cancellations and spectacular, hours’ long delays reported at major airports worldwide. We don’t have to fly to get to our embarkation/debarkation port, and we won’t have to leave** our cabin once aboard a ship unless we want to.
  • We booked two staterooms for our party of four, and one of them is a suite° with an extra large balcony. This is more space than we have ever paid for in the past, but we believe we might prefer to remain mostly cloistered while at sea, depending upon COVID case rates when and where we sail. We decided we wouldn’t travel without private access to fresh air, i.e., a balcony.
  • We reserved an additional, extra-fee private outdoor space for this sailing—on HAL’s fleet, these are dubbed Cabanas, placed in a restricted access area called the Retreat, and, again, booking one is a first for us—so we will have a dedicated area beyond our cabins to spend time if case rates exceed our comfort thresholds.
  • We’re prepared to skip going ashore at early stops in easily reached ports close to home in order to increase the odds*** we stay healthy for visits to rare, “bucket list” destinations further afield.
  • We’re each packing extra amusements that will allow any one of us to spend days on end alone in a room, and I’ve beefed up the travel medicine kit.
  • And, perhaps most important of all, we are setting sail having decided in advance that even isolating in our staterooms—aside from accessing our cabana via the stairs, no elevators—would be “enough” vacation to make the entire trip worthwhile. Dining on room service and entertaining ourselves on a balcony at sea will be sufficient, if not ideal. If we also get to enjoy the rest of the ship’s public amenities, all the better.

Until our embarkation, we won’t really know which activities will or won’t meet our risk tolerance and feel worthwhile. This is a higher than usual level of uncertainty for me to embrace. I acknowledge I can be prone to anxiety; I’m better known for demanding control than going with the flow.2012 Carnival cruise Saint John NB Canada - 1

Living through a pandemic serves to remind me, though, that life is short, and opportunities not taken can be lost forever. We have educated ourselves about the current situation with the virus, and we’ve prepared as best we can for such unpleasant scenarios as believing the risk of infection too high to risk socializing aboard ship or catching COVID at sea.

My kids are growing up fast. One will be moving away from home for the first time in just a couple of months. I want to take us all on one more vacation before it becomes necessary to negotiate with yet another adult life and all its mature entanglements to get away together.Woman hugs child

COVID-19 stole from everyone: lives, time, opportunities… I can’t know for certain that our cruise will be smooth sailing, but, if my analysis is correct, it should be worth the risk.

* Since there is no universal definition for “being careful” with regards to COVID, I’ll post mine. Our household choices in June 2022 continue to include:

  • limiting time inside any building beyond our home with the exception of one child who goes to school/camp in person,
  • wearing masks indoors anywhere but at home,
  • requesting that all visitors or tradespeople entering our home wear a mask,
  • wearing masks outdoors where social distancing isn’t possible,
  • antigen testing the kid who attends school/camp every weekend before he spends one unmasked afternoon per week with his grandfather (otherwise, that kid masks around Grandpa),
  • antigen testing our occasional visitors before eating or drinking with them,
  • only eating or drinking with visitors to our home outdoors or at a distance of ~10+ feet indoors.

We use—and offer those entering our home—several styles of N95, KN94, and surgical masks to ensure all this masking is as efficacious as possible. Even within the family, our faces don’t fit the same masks well.

See the CDC epidemiology paper referenced in paragraph three. The following quote comes from the Discussion section of that report, and it matches what I’ve read elsewhere over the past two years following pandemic news coverage:

“Spatial clustering was not identified on a specific deck or zone, and transmission does not seem to have spread to neighboring cabins, implying that droplet or contact transmission to nearby cabins was not the major mode of infection. Risk of infection did increase with cabin occupancy, but a relatively small proportion of cases in the same cabin had >4 days between their onsets, implying a common source of infection. Beyond that, however, the major transmission routes might include a common source outside the cabin and aerosolized fomite or contact transmission across different deck levels.”

I feel it is only fair to disclose that we had only paid a deposit for a fraction of the total cost, not the full fare for our cancelled 2020 vacation. Wagering many thousands of dollars would have felt foolish to me in support of a corporation, but a few hundred was an amount I could afford to lose with equanimity.

In particular, I found the crew aboard my past HAL sailing to be simultaneously professional and amiable. Keeping this subsidiary of Carnival Corporation in the black seemed likely to keep more of these excellent employees on the payroll during a bleak time.

**Apart from the mandatory muster—or lifeboat—drill. Cruise ships rightly enforce the requirement that every person aboard learns what to do in the unlikely event of an emergency at sea. Due to COVID, these are now conducted with less crowding and standing around in large groups than they used to entail.

°This will be our first experience of the Holland America Line suite category NS, or a Neptune Suite. The corner aft NS we chose is known for its exceptionally large balcony that wraps around the side and back of the ship, offering seating with more likelihood of shade-, sun-, or wind- protection than a standard balcony would.

***Testing positive for COVID-19 aboard a ship means a passenger will be quarantined according to that ship’s specific procedures. On HAL, last I heard, quarantined passengers are required to move to a balcony stateroom in a reserved section of rooms set aside and dedicated to housing those with COVID. On other lines, passengers quarantine in the stateroom they originally booked. In most cases reported by Cruise Critic board members, partners are given the option to stay together or lodge apart assuming only one tests positive.

We aren’t sure what will happen if both parents test positive but the young adults don’t, but we’re ready to live with the consequences either way.

These policies could change at any time, however, and I have read anecdotal evidence of ships adjusting rules on the fly by necessity when more passengers require quarantine than there were dedicated cabins for the sick.

Only Alaska & SW want mask scofflaws off flights

According to an Associated Press article I read in the Boston Globe, most of the major U.S. airlines are welcoming mask scofflaws back with open arms. This includes American, United, and Delta airlines.Disposable surgical mask

Quoted from the piece by David Koenig:

“Airlines have banned several thousand passengers since the pandemic started for refusing to wear masks. Now they want most of those passengers back.

American, United and Delta have all indicated that they will lift the bans they imposed now that masks are optional on flights.”

Putting that another way, American, Delta, and United do not care that passengers purposefully broke the law, disobeying the direct instructions of flight attendants, and putting other passengers at risk.

American, Delta, and United are choosing the potential profits to be earned off of contemptuous criminals ahead of the safety of everyone else in their planes.Pile of money

Message received, American, Delta, and United! You don’t want my business. I believe in the rule of law and the importance of passenger adherence to the lawful instructions of highly trained aircraft crew members. American, Delta, and United do not.

I pity the employees of these airlines, working for an employer taking the first opportunity to bring back customers who have demonstrated a willingness to violate §46504 of U.S. Code.Screen shot of U.S. Code section relating to interference with flight crew

Two smaller airlines—notably those known for more customer-friendly policies overall—took a different approach. Alaska Airlines* and Southwest both announced that law-breakers who refused to follow the instructions of flight attendants remain barred from their flights.

From the same article:

Alaska Airlines said this week that banned passengers won’t be welcomed back. Southwest said a judge’s ruling that struck down the federal mandate won’t change its decision to bar an undisclosed number of passengers.

Again, I have a simple takeaway here. Alaska Airlines and Southwest Airlines put passenger safety first. These are companies who value the health and safety of the people who board their planes, whether as paying customers or paid employees.Tail of Alaska plane visible on tarmac through airport terminal window

I will fly with Alaska or Southwest Airlines before ever again considering those other major domestic carriers. My sympathies are with the flight attendants who had to put up with selfish jerks intentionally breaking the rules; my dollars will fund companies that don’t reward churlish boors.

* I’ve written many times before that Alaska Airlines is my favorite domestic carrier. I have maintained frequent flier status with them for many years and frequently discover new reasons for this preference.

Facing pandemic persistence, I’ll spend where safety dictates policy

We have made it to August 2021. Sadly, the pandemic is not over, though the most vulnerable people in America have been tricked into behaving as if it is.

Decisions were made to re-open all venues while simultaneously dropping every protective precaution. Some of us believe that choice was precipitous, even reckless. I feel vindicated as my logic proves sound… but also so deeply disappointed.

I know I like redundancies more than most, but this seemed so obvious. “Better safe than sorry” may be trite, but it’s also wise where human lives are on the line.

How ’bout making one change at a time? After each change, observe the effect. It works for scientists, after all.

Oh, right, science is a tool for the liberal elite! Yet fools parroting such nonsense do it gasping through their fluid-filled lungs, crowding into our hospitals—institutions steeped in modern medical knowledge derived via the scientific method.

Some feel their lives aren’t worth living if they have to wear a mask to go shopping. Safety goggles, cloth face mask, and disposable gloves

I wonder how those precious snowflakes would hold up under conditions of true adversity. I imagine the oppressed population of Myanmar—or the people in Haiti or Tunisia, watching their fragile governments wobble under anti-democratic onslaughts—could offer lessons on what really constitutes a hardship to pampered American crybabies.

I would recognize that wearing a mask pales in comparison to being the target of genocide even had I never visited Auschwitz.

What a summer we could have had! If only we’d been cautious enough to resume access to theaters and restaurants, but with our masks in place for crowded, indoor conditions from the outset. It might have been the joyful reunion we all dreamed of during 2020’s isolation, loneliness, and despair.Woman hugs child

Hugging my grandma with a mask on didn’t lessen the joy of it. Visiting with my aunt over coffee on the patio instead of in the kitchen offered equal satisfaction. Espresso in demitasse cup on cafe table

Watching as my father’s “elective”—yet quality of life preserving—joint replacement surgery was postponed once, and then a second time, because no hospital bed was available was yet one more cost of the pandemic, but, this time, caused directly by bad actors, not a novel disease with unknown characteristics.

Now that stung.Analog wall clock showing 12:06

Frankly, I believe libertarian freedoms should be available… but only at a reasonable price. Partakers in those freedoms must give up the right to extort payment from the sensible majority.

Refusing vaccines? Fine, but wear a mask in public settings. Also, public funds—and even private insurance—should eventually cease to pay treatment costs incurred by those rejecting approved vaccines for endemic disease sufficient to be flagged by public health authorities.

The price of ignoring experts when an entire society experiences extreme events should be borne by those who choose to heed only their own counsel. That’s a fair trade off.

During outbreaks of any vaccine-preventable, endemic illness, refusniks must also give up the freedom to enjoy entertainment venues and public conveyances for all but essential purposes. Take your bus across town to work—while masked—sure, but recreational jaunts and all air travel unless, say, to receive urgent medical care out of state ought to be curtailed for those likely to spread disease.

NZ Chch bus MetroUnvaccinated kids should learn remotely unless masks are shown to be sufficient in preventing the spread of measles, chickenpox, the equally transmissible delta variant of COVID-19, and any future outbreak of similarly easily spread viruses.

If masks prove to work as well as that, I am 100% fine with unvaccinated kids—wearing masks—in schools forever. The point is to keep vaccine-preventable germs contained, not to dictate personal decisions that affect only oneself.

It should go without saying that the vaccinated should always be prioritized over the voluntarily unvaccinated when medical treatment becomes a scarce commodity that must be rationed. I hope and pray it doesn’t come to that, but, today, I fear for the people of Florida, Louisiana, and Arkansas. Mississippi and Alabama look pretty terrible, too.

Pandemic illness currently strains the pathetically insufficient “just in time” commercial hospitals in these and other states. An August 5th AP news story describes one Broward County hospital cramming beds into auditorium, cafeteria, and conference rooms to accommodate surging COVID-19 caseloads.

How pathetic that we allowed ourselves to fall back to this point more than a year after learning how and where this virus spreads!

Speaking to business owners and service providers, I reiterate that my personal spending will be concentrated in locations with high rates of vaccination. Pile of money

I will preferentially patronize restaurants and stores that demand proof of vaccination before letting anyone remove her mask.

It shouldn’t fall to commercial interests to manage a public health crisis, but dysfunctional politics brought us to that point. Re-opening—with precautions—allows for increased economic activity without excessive deaths. That’s the course I’ll vote for with my wallet.

Here’s hoping leadership by accounting departments can make up for the inadequacies of incompetent elected officials.

Post-COVID, I’ll remember NCL, Delta & Alaska Airlines put safety first

Norwegian Cruise Line (NCL) Holdings announced on May 7th that, if Florida’s government holds to its misguided law preventing private businesses from enforcing vaccine compliance, NCL will take all of its sailings to other ports outside that state. For a Miami-based company, that’s a pretty bold promise.

While my sun-loathing, beach-avoiding tendencies made Florida’s appeal a mystery to me in the past, its near total lack of sensible governance paints it as a positively terrifying “vacation” destination today. I’m hardly the only one to notice Governor DeSantis’ lunatic anti-corporate stance on this question, either.

I want to commend NCL for making a rational commitment to protect passenger safety even as the pandemic wanes. I haven’t cruised with Norwegian yet, but taking a firm line on this issue after a year of unprecedented collapse in the travel industry gives me a powerful reason to consider them more seriously in the future.2012 Carnival cruise Saint John NB Canada - 3

I’ve only taken a handful of cruises, having traveled twice with Crystal Cruises, once on Holland America Line, and once with Carnival. I’m delighted that Crystal has also adopted a 100% vaccinated passenger policy at this time.

At the same time, allow me to commend Delta for being the airline which blocked middle seats longer than any other major U.S. carrier. Delta ended that policy on May 1, 2021.

By contrast, American Airlines decided after just a couple of months in 2020 (April to June) that cramming passengers three abreast on flights of any duration—while an airborne virus sickened tens of thousands per day in a way science did not yet clearly understand—was sound policy.

AA made this choice well before the second surge of cases and deaths in the United States.AA entertainment welcome screen above pocket with A321S safety card visible

You can bet that Delta has moved up on the list of airlines I’ll choose to fly with going forward.

The day I got my first vaccine jab, I booked tickets home to see my dad for Christmas 2021.

I noticed when Alaska Airlines made the news for banning Alaska state Senator Lora Reinbold. The dis-Honorable Senator Reinbold repeatedly ignored staff instructions, violating a mask order designed to protect her fellow passengers.

Most of those good people were likely Reinbold’s constituents, yet she couldn’t be bothered to don a few square inches of cloth to reduce the risk of infecting them all with a contagious disease. The senator couldn’t know if any those in her vicinity were high risk; she simply didn’t care more about human life than she did political posturing.Tail of Alaska plane visible on tarmac through airport terminal window

I’m incredibly appreciative that Alaska Airlines chose to institute a face covering policy even before the United States federal government implemented its own mandate. I’m proud to say that Alaska is the airline with which I’ve had elite status for the greatest number of years.

I’m gratified that I’ve regularly paid a premium for flights with this airline that chose to do the right thing, even when doing so cost them the business of customers who couldn’t—wouldn’t—be bothered to take any small measure to respect others.

It’s interesting to me that I’ve long felt that customer service was better on Alaska and Delta than on other domestic airlines, even as frequent fliers began complaining bitterly about changes in the latter’s SkyMiles Frequent Flyer program devaluing their points. Personally, I prefer good service and more stringent safety protocols to a higher return paid in free trips.

This post is the product of a lot of noticing, over the course of a pandemic, which big companies took specific kinds of thoughtful action, and how often those actions corresponded with my previous impression of a given corporation. Trader Joe’s and American Airlines disappointed me; Delta, Alaska, and NCL have earned a great deal more of my esteem.

I have a long memory, and I’m the kind of traveler happy to pay a premium to support my values. Here’s hoping some pandemic-era changes in the aviation industry remain, and that the skies stay a little friendlier in the future.