Make your protective mask in fabric: with or without machine

Medical validation: June 10, 2020Dr Idris AmrouchePharmacist, DES doctor in the process of obtaining (anaesthesia-resuscitation)

Wearing a mask is compulsory in public enclosed spaces and now outside in some cities in France. If surgical masks are available for sale in pharmacies, supermarkets and on the Internet, you can also create it, but since January 22, the government has asked to no longer wear homemade masks.

1. Why wear a mask?
2. Which fabric to use to make your mask?
3. How many layers?
4. Tutorial to create a homemade mask
5. WHO recommendations for an effective mask
6. Precautions to take if you make a homemade mask

[Updated on January 22, 2021] The Minister of Health Olivier Véran asked the French on Thursday January 21 to no longer wear homemade masks. The objective: to prefer more filtering masks to deal with new, more contagious variants. He said during an interview on the set of TF1: "the HCSP (High council for public health) recommends to the French, and this is the recommendation that I also make to them, to no longer use the artisanal mask that we made at home".

The government is also asking to avoid industrial masks made of category 2 fabric, as they are the least effective. They filter 70% of particles compared to 90% for those in category 1. "On the other hand, I can tell you that 95 to 99% of the masks that you can buy in supermarkets, masks for the general public, are filter masks" reassured Olivier Veran. The decree containing this information must be published on Friday, January 22, according to AFP.

If the measure is difficult to impose in practice, "we ask that it be the norm from now on". The three types of masks that should be worn in public spaces are:

To be sure to equip yourself with the right masks, you must check their approval by looking at the logo indicated on the packaging.

According to the WHO, cloth masks are still as effective even against new variants of the coronavirus because the mode of transmission is the same, the organization said on Friday January 22. This is why, with regard to the recommendations in force, "we do not intend to modify them at this stage", said the head of the management of the pandemic at the World Health Organization, Maria Van Kerkhove. "Cloth masks, which are non-surgical, can be used by anyone under the age of 60 who does not have any particular health problems," she said. Faced with the French government's decision to no longer use certain fabric masks, "countries are free to take the measures they deem necessary", continued Maria Van Kerkhove.

The Academy of Medicine has also declared: "The reinforcement proposed by the HCSP is based on a precautionary principle justified by the risk of an epidemic resumption, but there is a lack of scientific proof: varying or not, the SARS-CoV-2 uses the same transmission routes, with the same ability to pass through face masks,” she said in the statement released on January 22. "Such a change in the recommendations concerning a practice with which the entire population had managed to familiarize themselves risks creating misunderstanding and reviving doubts about the validity of the official recommendations".

Faced with the decision of the government which recommends a distance of 2 meters, the Academy considers that "extending the distance from 1 to 2 m is a defensible proposal in theory, but inapplicable in practice", and recalls however that the gestures barriers are "more necessary than ever".

A new free distribution of masks

For the third time, a free distribution of masks is organized for individuals in precarious situations. Health Insurance specifies that the people who will receive the masks are the beneficiaries on December 24, 2020 of the Complementary Solidarity Health and State Medical Aid (AME). They will receive by mail free of charge between January 15 and February 15 six washable masks for each member over the age of 6. The sizes will be adapted according to the year of birth of the children.

Why wear a mask?

If FFP2 masks allow those who wear them not to come into contact with sputters or droplets potentially contaminated by a virus, this is not the case surgical or homemade masks. These are not intended to protect users from the virus. These devices prevent the projection of droplets or sputters from the wearer of the mask, but do not allow the latter to protect themselves from the particles present in the air. In other words, they help limit the spread of the virus. It is therefore interesting to wear a mask when traveling or even during a period of deconfinement.

A team of researchers from Yale University in the United States⁴ has also studied the countries where it is common to wear masks, in particular South Korea and Japan, and have compared to countries where wearing masks is not the norm like in Italy. According to their results, the masks reduce the rate of growth in both cases and deaths by up to 10%. More surprisingly, the economic benefit has been estimated at between $3,000 and $6,000 for each additional mask worn in public, due to the slowing of the spread of the virus.

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Adipose tissue

For Pr. Odou⁵, interviewed by Doctissimo, "you can wear a cloth mask when you are allowed to go out, but under several conditions. I think the problem is the misuse of masks. People use them without knowing how to put them on and how to take them off . A procedure must be followed to avoid contamination", advises the head of the pharmaceutical department of the Lille University Hospital and co-designer of a homemade mask for the general public. So be careful of the risk of putting your mask on your chin, then sliding it over your nose again, touching the filter area as well as your face. "In this case, its use is worse than better."

Wearing a mask is compulsory in closed public places and now in certain cities in France, including the capital. For reasons of practicality or ecology, you can make a fabric mask.

Which fabric to use to make your mask?

A meta-analysis of 25 scientific articles published in Mayo Clinic Proceedings⁶ assessed the effectiveness of the different models cloth masks. In general, this is effective: it makes it possible to avoid the transmission of the coronavirus.

“The literature we found clearly shows that face masks can reduce the spread of viruses and protect the wearer – some of them very effectively. This evidence should be more than sufficient to recommend their use, especially given the difficulty of controlling the ongoing pandemic,” assured Juan Jesus Carrero, professor of epidemiology and co-author of the study. "Cloth masks can offer substantial filtration, in some cases equivalent to some medical masks," the authors' report also read.

For the fabric, the scientists explain that they have not found any article that clearly indicates which are the best materials to use to make an effective mask against Covid-19. However, with the study of all the articles, they were able to list the three materials which offer the best possible protection:

How many layers?

Also according to this study, it would be necessary to sew three to four layers of muslin for the mask to be effective, and respect a certain number of threads: at least equal to 100 threads per inch, American unit equivalent to a deviation of 2.54 cm.

Tutorial for creating a homemade mask

Dr. Michaël Rochoy, general practitioner in Outreau, Pas-de-Calais, lecturer at the Faculty of Medicine of Lille co-created the site stop-postillons.fr⁷ which brings together nearly thirty tutorials for making protective masks: with or without seams, in fabric, paper or even plastic. Here are two.

A paper mask

You can for example create a paper mask. The tutorial, led by Prof. Daniel Garin, occupational physician and expert in biological and infectious risk, allows you to “make a mask to prevent the spread in the air of saliva particles which are potentially contaminated by the coronavirus”, explains the specialist in the video.

You will need:

How to do it?

1. Wash your hands with hydroalcoholic gel before touching objects;
2. Open the paper and fold it like an accordion;
3. Place a rubber band at the ends and fold up a piece of paper;
4. Now staple several times so that the rubber bands hold.

A mask fabric

Among the mask tutorials on Dr. Michaël Rochoy's website, here is a fabric mask approved by the FPS Public Health, the Belgian federal public service responsible for health. You can find the instructions with pictures here. The patterns are also available in pdf.

You will need:

1. For the outside (of the largest size): a piece of fabric at least 20 cm by 20.5 cm. This fabric should breathe well and should not absorb moisture. Preferably use a synthetic fabric (polyester), but cotton can also be used.
2. For the inside (of the largest size): a piece of fabric measuring 20 cm by 20.5 cm. Ideally use polypropylene but cotton can also be used.

How to do?

Before you start, sterilize your equipment (scissors, sewing machine, fabrics, filter, etc.) and your hands with hydroalcoholic gel or soap and water.

1. CUT MATERIAL: Seam allowance is included in the pattern. You no longer have to add it yourself. Cut four ribbons 50cm long, the fabric for the inside, the fabric for the outside. If your fabric is soft rather than stiff, make the outer fabric wrapper a little longer.
2. CREATE THE PLEATS: Press the hems on the short sides inward by pressing the fold of the envelope inwards then placing the fabric with the correct side up: the hems and the envelope are facing Table. Then fold the black line over the red line following the direction of the arrows. Repeat for each black-red pair. Squeeze the pleats (possibly one at a time).
3. SEW THE ENVELOPE: Use a 3mm straight stitch, a standard needle and synthetic thread are suitable for this. Sew the hems on the short side. Sew the envelope by sewing in the seam allowance.
4. SECURE THE PLEATS: If it is easier for you, you can stitch the pleats in the seam allowance to sew and close the pleats. side seams later.
5. MAKE THE CENTER SEAM: Place the two pieces with the correct side together and topstitch the center seam.
6. ATTACH THE RIBBONS: Tie a ribbon to each corner with a pin (check the drawing: the ribbons point inside the model). Press the hems of the short side inwards.
7. MAKE THE SIDE SEAMS: Fold the mask along the center seam (as if it were a slice of bread) so that the wrong side is on the outside. You can easily check this with the short side and envelope hem: these hems should be visible and the ribbons should be neatly tucked inside (like the toast topping). Sew the side seams, possibly using an overlock stitch. Immediately secure these seams by sewing a front-back-front part at the beginning and end so that the thread wraps around itself. Be careful not to sew the ribbons between the side seams!
8. TO DO THE PURPLE AND FINISHING TOUCHES: Turn the mask inside out along the open side (where the hem and envelope). If necessary, insert a filter in the mask.
9. STERILIZE: Wash the mask at 90°C. Then, store it in a sterile manner if you do not use it immediately.

The AFNOR-validated homemade mask

"AFNOR provides a free reference for facilitate and accelerate the mass or artisanal production of a new model of mask, known as a "barrier mask". This mask for the general public aims to protect the healthy population, in addition to the essential barrier gestures against the coronavirus", indicated the French Association standardization (AFNOR) in a press release. The agency is responsible for supporting and guiding professionals and individuals to develop national and international voluntary standards, including the manufacture of effective anti-coronavirus masks.

On its site, AFNOR offers various tutorials and provides several patterns for children and adults. You can thus easily build the protection of your choice (duckbill or with folds), and be certain that it best meets the conditions of effectiveness against the spread of viruses. The organization has even listed frequently used materials, specifying whether they are compliant or not.

WHO recommendations for an effective mask

A multi-page guide to masks and their effectiveness was published on June 5 by the World Health Organization ⁸. It recommends the wearing of non-medical masks in certain situations or places conducive to contamination such as in closed places or places with a high human density: shops, schools, in transport or in the event of gatherings.

The guide advises the wearing of medical masks in case of symptoms, for people over 60 or those who are vulnerable.

Regarding fabric masks, "the unlimited combination of fabrics and materials results in variable filtration and breathability" informs the guide. "Filtration efficiency depends on the tightness of the weave, the diameter of the fibers or yarns, and in the case of nonwoven materials, the manufacturing process."

Thus, the filtering efficiency of a fabric mask can range from 0.7% to 60%. The WHO specifies that a minimum of three layers allows better efficiency, the "ideal" combination being:

In addition, the shapes of the fabric masks can be "flat fold" or "duckbill" and must match the shapes of the wearer's nose, cheeks and chin. "When the edges of the mask are not close to the face and shift, for example, when talking, internal / external air enters through the edges of the mask rather than being filtered through the fabric" warns the l WHO. She adds that all masks must be able to be changed and cleaned properly at 60° and damaged masks must be thrown away.

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Precautions to take if you make a homemade mask

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