It’s been almost five and a half months since the first COVID19 case in India. The scientific experts and researchers are working hard to combat this global health emergency. We shouldn’t ignore the fact that in the coming times we will experience a massive spike in the cases.

The need of the hour is to keep ourselves safe and protected. There are several important guidelines issued by the World Health Organization (WHO) and the Ministry of Health and Family Welfare (MoHFW), India in this regard. Therefore, proper attention must be drawn regarding our safety measures in this pandemic alert.

Prevention is always better than cure. SARS CoV-2 is transmitted from person to person by respiratory droplets. Hence the best way to prevent a COVID 19 infection is by use of a face mask. Generally, there are three types of face masks available, the non-medical fabric face mask, the surgical mask and the N95 respirator. Let us understand how these three differ.

                          Table 1: Type of mask usage depending on different situations

 Type of maskFor use by      Can be used when…
Non-medical fabric face maskCommon public, cashiers, essential care workers, police, sanitary workers.Should be worn at all place where physical distancing is difficult- at grocery stores, pharmacies, at the workplace, social gatherings, public commute etc. 
Surgical mask (Triple layer mask)Healthcare workers in non-COVID-19 setup, persons with suspected COVID19 symptoms, Elderly persons with comorbidities like diabetes hypertension, lung disease, cancer or immune-compromised persons.Health care settings like OPDs, nursing home, clinics and home based care of ill patients etc.
Medical mask (N95 mask, mask with valves etc.) Health care workers directly involved in COVID care or treatment unit and confirmed COVID 19 cases.Community settings- Health care workers during contact tracing, screening units. Health care settings- COVID19 care and treatment unit.
Image 1: Non- medical or fabric mask
  • Non-medical fabric mask: Fabric masks are washable and reusable. This mask primarily prevents the wearer from possibly infecting others. It should consist of a minimum of three layers of different materials.
    • The innermost layer of a moisture absorbing material like cotton or cotton blends.
    • The middle layer acts as a filter and made of non-woven synthetic material like polypropylene.
    • The outermost layer made of moisture repelling material like polyester.

Medical Masks: Medical masks are types of personal protective equipment used to prevent the spread of respiratory infections. These masks cover the mouth and nose of the wearer and may be effective at helping prevent transmission of respiratory viruses and bacteria.

There are 2 main types of masks used to prevent respiratory infection: surgical masks, sometimes referred to as face masks, and respirators.

Image 2: Surgical mask
  • Surgical mask: as the name suggests, these masks are designed to keep operating rooms sterile by preventing the germs from the mouth and the nose of the wearer from contaminating a patient during surgery. Surgical masks are multi-layered consisting of a layer of textile covered by nonwoven bonded fabric on both sides. These masks are made with two filter layers effective in filtering out particles such as bacteria above 1 micron. The drawbacks are they are loose-fitting, does not provide a reliable level of protection against smaller particles and there is leakage around the edges of the mask when a person breathes. This must be discarded after disinfecting or destroying in covered bins after every single use.
  • Respirator: Respirators protect from exposure to airborne particles. Most N95 respirators are manufactured for use in construction and other industrial-type jobs that expose workers to dust and small particles. In healthcare setup, such devices protect from exposure to biological aerosols(suspension of liquid droplets in the air) including viruses and bacteria. Respirators are designed to achieve a very close facial fit and very efficient filtration of airborne particles. The edges of the respirator are designed to form a seal around the nose and mouth. N95 respirators block 95% of airborne particles. They are tight-fitting and prevent inhalation of smaller infectious particles that can spread through the air over long distances after an infected person coughs or sneezes.
Benehal MS8265 N95 Respirator with Breathing Valve Niosh Dustproof ...
Respirator mask
Image 3: Medical mask

Diseases that require the use of an N95 respirator include tuberculosis, chickenpox, and measles. N95 respirators cannot be used by individuals with facial hair or by children because it is difficult to achieve a proper fit. Surgical N95 Respirators are commonly used in healthcare settings and are a subset of N95 Filtering Facepiece Respirators (FFRs), often referred to as N95s. But now masks with valves are strictly prohibited to be used in hospital premises by staffs, patients or attendants as these valves allow unfiltered exhaled air to escape into the field that harms others.

Image 5: Face shield
  • Face Shield: wearing a face shield is an extra protective measure you can take in addition to keeping your distance, washing your hands, and sneezing into your elbows. The face shield’s full coverage deters the wearer from touching their face. These are inferior to mask concerning the prevention of droplet transmission. They may be easier to wear for individuals with limited compliance with medical masks such as those with mental health disorders, developmental disabilities, deaf people and children. It is always better to wear this with masks for greater protection.

The use of medical masks in the community may divert this critical resource from the health workers and others who need them the most. In settings where medical masks are in short supply, medical masks should be reserved for health workers and at-risk individuals when indicated.

But we need to remember that these masks alone cannot protect us from COVID19. We also need to practice the following: 

  • Tips for maintaining a healthy diet: While no foods or dietary supplements, in particular, can prevent or cure COVID19 infection, healthy diets are important for supporting and building a healthy immune system.
  1. Stay hydrated, drink plenty of water: Water is essential for life. It transports nutrients and compounds in blood, regulates your body temperature, gets rid of waste, and lubricates and cushions joints.
  2. Eat a variety of food: every day try to eat a mix of wholegrains- rice, wheat; legumes such as lentils, beans; plenty of fresh fruits and vegetables; and some foods from animal sources (meat, fish, egg, milk etc.). Choose unprocessed whole grains such as maize, oats etc which act as a good source of fibres and helps us to feel full for longer. For snacks, you may use raw vegetables, fresh fruits and unsalted nuts.
  3. Cut back on salts – limit salt intake to less than 5gm/day
  4. Eat moderate amounts of fats and oil.
  5. Do not overcook- as it can lead to loss of important vitamins.
  6. Limit sugar intake- limit the intake of sweets and sugary drinks.
  7. Avoid hazardous and harmful alcohol use- Alcohol is not part of a healthy diet. Drinking alcohol does not protect against COVID 19.
  8. Breastfeed babies and young children – breastmilk is the ideal food for infants. It is safe, clean and provides antibodies that provide protection against many childhood illnesses. (maintain respiratory hygiene, wash hands before and after touching the baby, routinely clean and disinfect surfaces).
  • Coping with stress: It is normal to feel sad, stressed, confused, scared or angry during a crisis. We all have a role to play in protecting the physical and mental health of ourselves and others.
  • Talking to people you trust can help lessen the distress.
  • Choose a fixed and limited time to check on COVID 19 updates. Gather information from credible sources such as WHO or, a local or state public health agency.
  • It’s important to spend time to spend doing things you enjoy and find relaxing.
  • Contact your friends and family. Maintain social contacts with loved ones at home, family and friends through phone and video calls or internet.
  • Maintain a healthy lifestyle including proper sleep, exercise.
  • Practice your regular routines and schedules as much as possible.
  • Avoid using unhelpful coping strategies like alcohol, tobacco or other drugs.
  • Protect yourself and be supportive of others- check-in by phone on your neighbours and your community who may need extra assistance.
  • Watch for symptoms: COVID-19 affects different people in different ways. Most infected people will develop mild to moderate illness and recover without hospitalization. They are as follows:

      Most common symptoms:

  1. Fever.
  2. Dry cough.
  3. Tiredness.

     Less common symptoms:

  1. Aches and pains.
  2. Sore throat.
  3. Diarrhoea.
  4. Conjunctivitis.
  5. Headache.
  6. Loss of taste or smell.
  7. A rash on the skin, or discolouration of fingers or toes.

     Serious symptoms:

  1. Difficulty breathing or shortness of breath.
  2. Chest pain or pressure.
  3. Loss of speech or movement.

          Always call before visiting your doctor or health facility.  People with mild symptoms who are otherwise healthy must seek online/virtual medical advice to manage their symptoms at home. On average it takes 5–6 days for symptoms to appear ( from the point of contact with the virus) however it can take up to 14 days as well. Seek immediate medical attention if you experience any of the serious symptoms.

  • Fact: As of date there are no specific medicines or treatment guidelines that can prevent or treat COVID19 adequately. However, those infected with the virus should receive appropriate care to relieve and treat symptoms, and those with severe illness should receive optimized supportive care. Some medical treatment protocols and vaccines are under research and investigations and some others are being tested through clinical trials. Therefore, be informed, be prepared, be smart and be safe.

References:

  1. Advice on the use of masks in the context of COVID19. Interim guidance: Geneva; World Health Organisation: 5th June 2020.
  2.  Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
  3. Available from:https://www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome—healthy-diet
  4. Coping with stress during the 2019-nCoV outbreak. Guidance: Geneva; World Health Organisation: April 2020.
  5.  Available from: https://www.who.int/health-topics/coronavirus#tab=tab_3.