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Coronavirus Mailbag: What’s the most effective material for homemade face masks?

By Carter Williams, | Updated - Apr. 10, 2020 at 8:58 p.m. | Posted - Apr. 10, 2020 at 6:50 p.m.

Editor’s note: These answers are based on interviews and information current as of the time of publication. Please be aware that new information may be discovered by health experts after publication. We’re working to keep this information as up-to-date as possible.

SALT LAKE CITY — Since our last mailbag article, there have been a few key COVID-19 developments that answer some of the questions you’ve asked us about the coronavirus.

As of Friday afternoon, the Utah Department of Health reported 2,102 confirmed cases of COVID-19 in the state and 17 deaths. Worldwide, more than 1.6 million people have been infected with the disease, and 100,000 people have died from it, according to the Johns Hopkins University’s COVID-19 Global Cases by the Center for Systems Science and Engineering.

On Apr. 3, President Donald Trump recommended that people who have to go outside wear homemade masks if they can.

We know you still have questions about the coronavirus, safety measures and other things related to COVID-19 during all these developments. So, here are answers we’ve found to some of the questions you’ve asked us.

What’s the most effective material for homemade face masks?

Homemade masks have been a popular question over the past few weeks and are especially relevant following the national recommendation. Let's start by looking into why they are recommended.

"The recommendation behind the general public wearing homemade masks is that we have identified, throughout the course of this outbreak, that asymptomatic spread is not only likely, it’s probable," Utah Department of Health state epidemiologist Dr. Angela Dunn said during a press conference Thursday. "And so, if someone is even mildly symptomatic and they’re wearing a homemade mask, they are less likely to spread the disease to others."

She expounded on this topic further during Friday’s press conference.

"They (masks) should be used in instances where social distancing greater than 6 feet from individuals is not possible," Dunn said. "Social distancing is still paramount to containing this outbreak, but there are instances, such as going grocery shopping or going to a pharmacy, where it might be hard to maintain that 6-foot distance. In those instances, it can be helpful for individuals to wear a homemade mask."

It’s important that medical-grade masks, which are more effective than homemade masks, should go to medical workers because the products remain in short supply, she added.

So what are the best materials for a homemade mask? A study found some of the best materials for filtering microscopic particles that you can wear are 600-count pillowcases and pajama-like flannel material; stacked coffee filters were decent and scarves and bandannas had poorer scores, the New York Times reported on Thursday. Researchers explained there needs to be a balance between effectiveness and being able to breathe, so items like HEPA filters and vacuum bags, despite scoring highly in filtering particles, aren’t suggested mask materials.

The study also found that homemade masks with quilting fabric fared very well compared to many other options. It’s worth noting that recommendations by the Centers for Disease Control and Prevention say any sort of cloth is perfectly fine. That can even be a rolled-up t-shirt.

There are some other guidelines you should know. The agency says all masks must:

  • fit snugly but comfortably against the side of the face
  • be secured with ties or ear loops
  • include multiple layers of fabric
  • allow for breathing without restriction
  • be able to be laundered and machine-dried without damage or change to shape

The CDC also states people should not touch their eyes, nose or mouth while taking off their mask and should wash their hands immediately after they have taken it off. They also recommend that people regularly wash their cloth masks.

I live in Wyoming. If I come to Utah to shop at Costco, do I have to fill out a form?

Gov. Gary Herbert’s announcement about a travel declaration, which went into effect Friday and will run through at least May 1, was a big local development from this week. The declaration is an online form people coming into the state from 10 different entry points (nine by road and another at Salt Lake City International Airport) will be asked to fill out if Utah is your final destination. The form asks those filling it out if they’ve been tested for COVID-19, if they’ve recently had COVID-19 symptoms, and details about their recent travel history.

State officials pointed out people don’t technically have to fill out this form, but government officials hope that people will. It’s important, they say, because it helps in tracing and mitigating the disease.

"We are able to inform travelers about public orders in Utah and we are able to isolate incidents and notify anyone who may be affected," officials wrote in a question-and-answer form, on the state health department’s website.

But what about people who live in neighboring states who come to Utah for things like shopping? First off, you will only get the message notification if you are coming through the nine roadways. Those are:

  • I-15 at the Arizona or Idaho borders
  • I-70 at the Colorado border
  • I-80 at the Nevada or Wyoming borders
  • I-84 at the Idaho border
  • U.S. Highway 40 at the Colorado border
  • U.S. Highway 89 near Kanab
  • U.S. Highways 491/191 near Monticello

In this particular case, if you come into Utah through I-80, you should only receive this message once between now and May 1. And, yes, it’s recommended that you fill out this form, Utah Department of Transportation spokesman John Gleason said.

"If they’re shopping at Costco, there’s a risk of exposure for themselves or anyone at the store," he explained.

This, he added, applies to anyone coming into Utah for work, to visit someone or for shopping. It’s worth pointing out that the state health department says someone who travels back and forth between Utah and the state only needs to fill out this form once.

When the Utah Department of Health says ‘the number of people hospitalized,’ is that number the total since the pandemic started (like the total cases), or is it how many people are hospitalized right now?

Following up on a question from last week, the department first started reporting hospitalizations the day after that mailbag ran. As of Friday, the state reports 183 hospitalizations, which equates to about 8.7% of all confirmed cases. This is a good question, and it was clarified by Dunn during a press conference on Monday.

When the department lists hospitalizations on its website, those are the total number of people who have been hospitalized due to COVID-19 since the state began receiving cases. That means they don’t represent the current number of people hospitalized, but include those who were either discharged from a hospital or died at one, she explained.

How many ventilators does Utah have?

There are a little less than 1,000 ventilators and about 600 total ICU beds statewide, according to the Utah Department of Health. Now, here's what that means within the context of Utah's COVID-19 situation.

As of late last week, about 297 ICU beds were in use, and most of those were for people not affected by COVID-19. Of the ventilators, only about 28% of the state’s ventilators were being used, and most of them were being used for non-coronavirus reasons.

The number of hospitalizations is slowly rising in the state. The state has reported 45 new hospitalizations from Monday to Friday, which is nearly a 33% increase over a five-day span. When state health department leaders spoke about numbers late last week, they anticipated needing 284 ICU beds for COVID-19 patients by about April 21.

“We are predicting for a surge in needed health care and hospital beds,” Dunn said on Friday, adding that not all coronavirus models will be accurate given the lack of information about the novel disease. “We are working to make sure we are preparing our health care systems so they can deal with any surge if that indeed happens. But we don’t have a good prediction, if you will, but we are preparing now in the event, any day, we could see a huge surge.”

Who is tracking people that are getting better? What are those stats telling us?

Tracking recovery is mostly dependent on tracking the health of every single person with a confirmed case — and it's hard for Utah health experts to do this. If Utah’s hospitalization trend holds up, it means nine out of every 10 Utahns who get the disease will likely recover without ever going to the hospital, so it's difficult to track recovery. Dunn has said this often during daily updates provided by the state health department.

Some states have clearer answers on recovery, so that’s why it gets reported. This stat is still important. It tells us the majority of people who end up with COVID-19 will fight it off and be OK.

How can I get tested if I don't drive?

We’ve reported on the growth of drive-thru test locations, so this is a good question to clarify. What if you don’t have a car or can’t drive? First off, people can go to the state health department’s website to find their nearest testing location. If you call ahead at that location, you will be directed as to how to safely get to that site and be tested.

Dunn explained that the Utah Department of Health also has mobile vans that can go to sites and test those who can’t make it to a hospital, testing center or drive-thru site, as well. Those, she said, are used on a case-by-case basis.

How do you keep animals safe from getting the coronavirus?

We answered a similar question in a previous mailbag. Early on, the CDC recommended limiting interactions with your pets as much as possible, especially if you are exhibiting COVID-19 symptoms.

"If possible, a household member should be designated to care for pets in the home. If the individual in home care and isolation must care for pet(s), including service animals, they should ensure they wash their hands before and after caring for pets and wear a facemask while interacting with pets until they are medically cleared to return to normal activities," the agency posted on its website.

There was a major development that happened a few days after a reader submitted this question, which prompted us to revisit the topic. A tiger at a New York zoo tested positive for SARS-CoV-2, which is the novel virus that causes COVID-19 in humans, the Department of Agriculture said Sunday. While this new virus originated from an animal source, this was the first documented case of the virus being transmitted from human to another animal. It’s unclear if the coronavirus can spread animal to animal or pets to humans.

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"Anyone sick with COVID-19 should restrict contact with animals, out of an abundance of caution, including pets, during their illness, just as they would with other people," agriculture officials said in a prepared statement. "Although there have not been reports of pets becoming sick with COVID-19 in the United States, it is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus. If a sick person must care for a pet or be around animals, they should wash their hands before and after the interaction."

In a question-and-answer portion of the press release, department officials said: "We are still learning about this new coronavirus and how it spreads. This case suggests that a zoo employee spread the virus to the tiger. Further studies are needed to understand if and how different animals could be affected by COVID-19."

The tiger was tested after exhibiting respiratory illness symptoms. The agency recommends that anyone whose pet comes in contact with a COVID-19 patient and is exhibiting symptoms of illness, should contact their local veterinary clinic and inform them of the possible exposure.

"Veterinarians who believe an animal should be tested will contact state animal health officials, who will work with public and animal health authorities to decide whether samples should be collected and tested," the agency states.

Once the quarantine and restrictions are lifted, there will still be cases of COVID-19 going around. How are we going to prevent a huge flare-up of cases again? Is it going to be a never-ending cycle? Is it going to come around every year like the flu?

History might be the best way to answer this question because it’s what will dictate how guidelines will be handled until a vaccine is readily available.

By now, you’re all likely familiar with the 1918 influenza pandemic, which killed at least 50 million people worldwide. We’re already experiencing one of the most important lessons from that pandemic: social distancing. But one of the reasons that outbreak was so devastating is that it came through in three major waves that carried all the way from spring 1918 through summer 1919. For example, thousands in Philadelphia died after contracting the flu while attending a citywide parade about the same time the second wave began to ravage the U.S.

The lessons of the 1918 pandemic remain relevant today because there likely won’t be a vaccine widely available until at least next year.

"There is a possibility we will see waves of this. There’s a possibility that it’s seasonal and it could resurge in the fall," Dunn said on Wednesday. "Those elements we just don’t know yet because it’s novel, but we are prepared for them."

These restrictions won't also be lifted all at once, Dunn explained again on Friday.

"The health department is working with the governor's office in order to identify how to slowly reopen schools and business so that it's not all shut down and then all open," she said. "Hopefully, with that kind of slow rollout, we will be able to minimize the potential for a resurgence in cases."

Going back to the 1918 influenza, The Church of Jesus Christ of Latter-day Saints moved its Apil 1919 general conference to June that year because of the third wave. If we think in terms of how it was handled then, it’s possible we’ll see some restrictions and measures until there is a vaccine or another viable treatment for the disease.

While those are all long-term possibilities, Dunn stressed that it's important that Utahns focus on staying home and social distancing now to stop the spread of the disease in the state happening now.

"My advice is to, first, focus on this current increase. Let’s get it down, let’s start seeing the decrease in cases," Dunn added. "In the background, public health is working with partners for that preparation in case we do see cycles or resurgence moving forward."

When will COVID-19 go away?

This sort of goes back to the previous answer. Even if Utah’s cases subside in the coming weeks, there’s still a possibility it could come back in the future.

To expand a bit more on vaccines and treatments, Intermountain Healthcare and University of Utah Health announced Wednesday they’re starting a trial study to test how effective hydroxychloroquine, an anti-malaria treatment drug, and azithromycin, a drug commonly used to treat bacterial infections, are in treating COVID-19.

"We want to test this in a pandemic; we want to know if it works," Dr. Raj Srivastava, an investigator for the Intermountain Healthcare trial, said during Wednesday’s press conference.

The results of that study are expected to be available this summer.

As for a vaccine, the first vaccine trial in Washington State is still in progress and a different vaccine trial started this week with volunteers in Kansas City, Missouri and Pennsylvania. There are dozens of other vaccine trials across the globe expected to begin in the coming months, as well, according to the Associated Press.

That doesn’t change what Dunn and other health experts have said numerous times over the past few weeks. It will likely take at least 12-18 months from the start of a trial to finish before something ends up on the market.

If you have questions about the new coronavirus, please submit them to the Google response form below for future installments.

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