Medical masks or surgical masks? What's the difference between both classes of masks? Or are there any differences at all? Well, we won't know if we don't try to find out. And that's what we'd be doing right now. 

2020 has seen masks take on a higher level of importance than ever. We've always known that masks can be used by healthcare workers and the general population to prevent disease spread, but we've often not paid any mind to them. 

That nonchalance, of course, could only last for a while. The coronavirus has forced us to take all the knowledge we have about infectious diseases seriously. We now have had to put on masks, wash our hands thoroughly, and generally stay away from people. 

While these measures have helped slow down the spread of the virus, they have been by no means seamless. As expected, there have been questions, confusion, and general misunderstanding on the measures to stem the tide of infections and shut down the virus. One of such misunderstandings has been on the issue of masks. 

For one, what kind of masks work? We know that cloth masks or masks made with fabrics are more effective at stopping the wearer from spreading the virus than at stopping the others from contracting it. But how effective are these masks? 

It doesn't stop there. Many health authorities have spoken on the need for doctors to wear surgical masks— while some have spoken at length on the need for medical masks. And to be fair, at some point it does start to get confusing. Are these people talking about different things? Or are they referring to the same things? Or is there some sort of confusion over the kind of mask to be used? 

Well, today we find out.

 What's the difference between both kinds of masks? Is there even any difference?

What's The Difference Between Medical Masks and Surgical Masks? 

There's no functional difference between both classes of masks. While there are different examples of the same type, they all fall under the same class. Basically, medical masks and surgical masks are one and the same. There's absolutely no difference between both masks. 

Whenever people talk about surgical masks and medical masks, they are generally talking about or referring to the same kind of masks. And it's not an unknown or strange mask either— it's the kind you've seen in clinics and hospitals a thousand times before. 

A surgical mask is a loose-fitting and disposable barrier that is often used to create a physical barrier between the face of the wearer and contaminants that may exist in that environment. When worn correctly, these masks will block liquid droplets, sprays, splashes, splatter from reaching the wearer's mouths and nose. These masks also do an excellent job of reminding people not to touch their faces with infected hands, which is an important lesson to learn during pandemics. In fact, you could argue that it's probably the most important lesson to learn during pandemics, and if the general population simply followed that one rule, we'd be rid of the pathogen a lot quicker than normal. 

In some quarters, surgical masks or medical masks are meant to be worn by healthcare workers during healthcare procedures. The procedures that require masks are usually surgeries, so it's not difficult to see how the mask got its name.

This class of masks is intended to protect against infections of both patient and doctor. While surgical masks today often refer to respirators that prevent the spread of coronavirus, that's not all there is to these masks. For one, the masks are usually designed to prevent infections by catching bacteria shed in liquid droplets and aerosols from the wearer's mouth and nose. And how do we know that these masks work? Well, there's a mountain of evidence that proves the effectiveness of masks in limiting the spread of diseases. 

These masks were created to help protect health workers against splashes, sprays, and all other forms of bodily fluids. However, the masks' effectiveness against influenza-like disease has not yet been proven— despite many attempts to do so. 

Interestingly, these masks aren't only called surgical masks and medical masks. There are loads of other names they go by. Some include procedure masks, layer masks, face masks, and even fluid-resistant masks. 

Not all surgical masks are the same. Some surgical masks are not even appropriate for surgery. Masks vary according to their protection and construction levels, and it's the same for surgical masks. Some surgical masks include dental masks, isolation masks, medical procedure masks, or just plain surgical masks. 

Quality

The performance of surgical masks is evaluated based on filtration, exposure, liquid penetration resistance, water repellency, air, water vapor permeability, and mask airflow resistance. 

 Surgical Masks

Most surgical masks came into the mainstream in the 1960s and immediately replaced cloth face masks in developed countries. 

Surgical masks make use of nonwoven fabric that is created through a melt blowing process. The masks are usually three-ply. Three-ply, in this sense, refers to the three layers that make up the mask. The three-ply material is made up of melt-blown polymer that is placed in between nonwoven fabrics. 

This melt-blown material is what acts as the filter that stops microbes from entering and exiting the mask. Pleats are added to the mask to allow the wearer to extend it so that it covers the nose and mouth. 

The dark green (or blue) side of the mask is meant to be worn outward, while the mask's white side should be the side to cover your face and mouth directly. This is because the dark green side is fluid repellant, and the white part of the mask is absorbent. It's little wonder that doctors usually use these masks to prevent the spread of infectious diseases. 

Sadly, even surgical masks have their limitations. They are usually inadequate to deal with influenza-like diseases. A big reason this is so is that they are not constructed to protect the wearer from breathing airborne bacteria or viruses. This means that these kinds of masks would become rather useless to healthcare officials when a pathogen that spreads through this exact method starts off a pandemic. 

And this is precisely what has happened in the case of the coronavirus. While the virus does spread in liquid droplets, so a huge chunk of it can be caught by the surgical mask, it also spreads through very, very tiny organisms in the air. Surgical masks try to retain respiratory droplets released from the wearer through coughing, talking, or sneezing. However, some diseases (like the coronavirus) spread through way smaller particles that the mask cannot hold. 

Surgical masks, by design, cannot filter or block these small particles. These masks do not provide complete protection from bacteria, viruses, and germs because of the loose hold that the masks face. Unlike other respirators, surgical masks don't have a firm fit to the face. This means that bacteria and germs can sneak into the mask through other places. 

That's why surgical masks are no longer enough for healthcare professionals dealing with Covid-19. They now need something more— something like the N95 respirator. 

Surgical Masks And Respirators 

The first thing to note is that surgical masks are not the same as respirators. It could be fatal to conflate both terms. 

Surgical masks are not respirators, and they are never certified as that. When health authorities speak about respirators, they are talking about a distinct class of face masks— not medical or surgical masks. 

Unlike respirators, surgical masks are not designed to protect the wearer from inhaling virus particles or airborne bacteria. Respirators are explicitly designed for this purpose, which makes them invaluable when pathogens spread through these means cause an epidemic or pandemic. It's little wonder that health authorities worldwide have advised healthcare workers to only use N95 respirators when responding to coronavirus patients, as it's the only way to prevent the spread of the disease.

N95 Respirator

An N95 respirator is a personal protective device or face mask designed to achieve a very tight facial fit. This facial fit ensures that there can be no contamination of the area inside the mask. As you may expect, these masks are most often used in healthcare environments, and they are a subset of N95 Filtering Facepiece Respirators (FFRs). 

However, there are some similarities between N95 respirators and surgical masks. One, they go through the same test protocols. They both go through fluid resistance and filtration efficiency (this test encompasses particulate filtration efficiency and) bacterial filtration efficiency, flammability, and biocompatibility tests. Another similarity is that under normal circumstances, these masks are single-use.

Although, in extraordinary circumstances, they could be used approved for extended use or limited reuse. Extended use, in this case, refers to using the respirator or mask for more than one patient. Ideally, surgical masks and N95 respirators should be discarded after contact with one patient. Using the same surgical mask or N95 respirators for different patients is what is called extended use. 

On the other hand, limited reuse is the reuse of the N95 respirator for a limited number of times. It's important to note that these measures are only put in place where there's a shortage of respirators. This often happens during a pandemic or epidemic.

In fact, due to the shortage of N95 respirators, the WHO, very early in the pandemic, began recommending that institutions put measures in place to prolong the use of their respirators. These measures included emergency authorization for limited reuse and recommendation for extended use. 

But it appears that even these extraordinary measures could not supply hospitals with the masks needed adequately. With the supply of N95 to hospitals not meeting demand, things have even managed to get more desperate. These days, industrial-grade N95 is now being used by doctors instead. This wouldn't be alarming if surgical N95 and industrial N95 masks are of the same quality. But they aren't. For one, these industrial-grade N95 masks lack the fluid resistance that you'd get with a surgical N95. 

Thankfully, some healthcare institutions are getting around this problem by using a face shield. That way, the fluid resistance of the mask wouldn't have to be called into question. 

Precautions To Take With N95 Respirator

The N95 is the best mask we have to fight against the coronavirus, but it's certainly not a magic wand that one can wave. Wearers of the mask will have to take certain precautions to ensure that the mask is effective and that wearing it doesn't cause more problems than it solves. 

  • First off, people who have chronic respiratory conditions that make it difficult to breathe well should avoid wearing an N95 respirator. If they must wear it, they should consult their health care provider to make sure the respirator won't cause any problems. This is because respirators make it more difficult to breathe; this could pose a massive problem for people with breathing issues. 
  • If you've got a beard, you've got to cut it all off before using an N95 respirator. The respirators are not designed for people with facial hair, as the hair makes it extra difficult for the mask to form a quick seal over the face. Additionally, the mask shouldn't be used on children. This is because the mask cannot form a strong seal over the face of children as well. 
  • Some N95 masks have exhalation valves that make it easier to breathe in and out. These valves also help to deal with heat build-up too. However, these models should never be used when sterile conditions are needed. 
  • All FDA N95 masks are labeled as single-use. This means that they should be discarded immediately after use. If you notice that your respirator has become damaged or your breathing has become labored or complicated, you should remove the respirator, discard it, and then replace it. It would help if you always use gloved hands to handle the respirator and wash your hands thoroughly after removing the mask.