(Pictured: Maison Marvaan has outfitted its bamboo and hemp masks, originally made for dusty desert festivals, with an extra surgical style layer to go under the top layer. The brand is clear that it is not meant to protect medical workers from COVID-19 and is for consumer use only.)
By May Yang, the founder of the luxury leather goods label Lidia May.
Like many of my peers in the fashion community, I felt the urge to do something to help when I read countless stories about the shortage of Personal Protective Equipment (PPE) for frontline medical workers around the world. In Bangladesh, where my label is based, already crowded hospitals are bracing for the worst. As a former aid worker turned fashion social entrepreneur, I thought I could respond to the call for help.
The Bangladesh public health and aid community is a small one, so I have the privilege of knowing leading doctors, disease researchers, and public health professionals, who I contacted weeks ago to ask if fabric masks would be helpful.
Their resounding answer was “No.”
Since then, I’ve become deeply concerned about fashion businesses announcing they are making and donating fabric face masks to hospitals. From small design houses to large brands, every day I see another brand jumping in to join the cause. With any normal marketing in a time of crisis coming off as tone-deaf, I understand the drive to give your PR person something positive to talk about. But making masks for medical workers is a far more complex process than sewing a piece of fashion.
If you’re a designer or fashion brand and you are considering producing masks for hospitals, I hope you’ll take a minute to read this.
The problem with fabric masks
After my idea was rebuffed by the experts, I did some more digging into the science of mask making and realized what a terrible idea cloth masks are for medical workers. They can actually increase the chance of infection.
Fabric fibers are thick and porous relative to the size of virus particles and droplets (from spit or coughs, for example) so virus droplets can pass through the material to your nose or mouth. One 2015 study showed that 97% of particles pass through cloth masks, compared to only 44% through medical masks.
There are more thickly woven fabrics that can filter out some droplets, but the tradeoff is breathing becomes difficult and the user cannot wear it for very long. This is not a problem for us going out to run errands, but a serious issue for medical professionals with long and physically demanding shifts.
Fabric masks also become humid as you breathe and talk into it. When the mask fabric retains moisture, it is much easier for the virus droplets to pass through, according to a study from 2013, which, ironically, was done to guide policy in underdeveloped countries like Bangladesh, not countries like the United States.
For all these reasons, wearing a fabric mask in a job or area with high exposure to respiratory viruses is very risky.
Why medical masks are different
There’s a reason why all the medical professionals are asking specifically for N95 and surgical masks. These masks contain a crucial filter made of “melt-blown fabric.” At one-seventy-fifth the diameter of human hair, it’s a super-fine textile that allows you to breath while still filtering out 95% of infectious particles.
It’s also super rare. Only a handful of companies around the world have the right machinery and expertise to make melt-blown fabric. According to NPR, to set up a new production line to make it requires over $4 million in equipment costs and at least six months. Existing factories are not able to cope with the surge in demand, so the melt-blown fabric is slow coming. There’s no filtering fabric that can replace melt-blown polypropylene right now.
So you see that the bottleneck is the material, not lack of mask manufacturers. You simply cannot make medical-grade masks without medical-grade materials.
If you’re a company looking for melt-blown fabric or masks, you might find some! But it will probably be counterfeit, as unscrupulous manufacturers are exploiting the crisis to make a quick buck, and there’s evidence that masks are now being made in sweatshops in unsanitary conditions. If you seem to stumble upon a supply, make sure the company is listed on your government’s approved list. For example, the U.S. Center for Disease Control and Prevention has its approved list here.
I’m aware that in some cases, hospitals have reached out to brands for help in making cloth N95 mask covers, to extend their life at a time when the rule against wearing them for more than one patient has been thrown out the window. However, at this point, the few hospitals who are open to this unorthodox approach have had their needs already met by manufacturing facilities that can put out more than 10,000 masks a week. Brands are reportedly sitting on piles of fabric masks that they don’t know what to do with. And be careful about sewing PPE for your friends who work in hospitals. Some nurses who have come in with their own PPE against hospital guidelines have been punished.
So please, fashion businesses, let’s stop making fabric masks as donations to medical facilities, and find more creative and meaningful ways to help that align with our skillset.
How the fashion community can help
Experts are starting to say that everyone should wear a mask when in public, in order to slow down the spread of COVID-19 from asymptomatic individuals. There is about to be a run on masks, but with the global shortage, the masks available to buy online are low-quality and overpriced.
When combined with regular hand-washing and social distancing, double-layered fabric masks made with a densely woven fabric are better than nothing. They can be useful for preventing people from touching their nose and mouth with unclean hands, and could potentially slow the spread from people who have COVID-19 and are infectious but don’t know it because they are asymptomatic. We also need to help our frontline medical workers access proper medical masks and other PPE by keeping those items exclusively for them. For all these reasons, a fabric mask can be a good option for the general public.
This is something the fashion community can do. We are in the business of creating objects of desire, of giving people an avenue for self-expression. And right now, people want to express their commitment to protecting their community, to express their gratitude to the frontline healthcare workers, and to express hope for better days to come. The fashion community could do what it does best, by designing and selling kick-ass fabric masks to customers. For an extra dose of altruism, the sales of those masks could then fund the creation and donation of more masks to low-income people who by nature of their socioeconomic status are less able to socially isolate.
So let’s focus on doing what we’re good at, and leave the skilled manufacturing of regulated medical supplies to the experts.
May Yang is a Chinese-American former aid worker, and founder of the luxury Bangladesh leather label Lidia May, which trains and fairly pays female embroiders and local leather workers, upskilling them out of fast fashion and into the luxury sector while financially benefiting the nonprofit Lidia Hope Centre. You can read more about Lidia May at Refinery29.