Masks for larger faces: What DH prefers

None of the links are affiliate and these companies don’t know we exist.  No amazon links because they have no quality control and sell fakes.

I recently went to a couple of conferences where there were several gentlemen with larger faces who complained about not having masks that they felt comfortable in.  All of them were wearing ill-fitting KN-95 with ear loops.

With my well-fitting KF-94s, I often forget I’m wearing a mask because they’re breathable and comfortable, and with some adjustment I can keep my glasses from getting fogged up.  Comfortable and breathable masks make it so much easier to keep a mask on.

As a reminder:

N-95 are the US gold standard of masks with the loops that go around the head.  If you don’t want something on your ears, that’s what you should go with.  These tend to be made for larger faces because they were originally intended for construction workers who are mostly male.

KN-95 are usually in clamshell form and have loops that go around your ears.  They’re generally made in China and there are a lot of fake masks out there.

KF-94 is the South Korean standard.  These tend to have higher quality control because the Korean government gives large fines to companies that don’t meet their standard.  They are usually over the ears and in boat shape, which I find to be more breathable than the clamshell mask.

DH’s go-to mask is the Airwasher LG black KF94 .  He used to use the BOTN large (green packaging), but they changed how they do the nose wire so we don’t like them as much.  This is just a good breathable large mask with ear loops.

When we’re flying or he’s going to the doctor’s office or otherwise needs an N95, his preferred N95 is the 3M VFlex N95.   This is the most goofy looking of the 3M N95 lineup, but it is also extremely breathable and pretty comfortable.  He‘s also fine with the standard 3M N95 and the Honeywell N95, but the VFlex is so incredibly breathable that we bought a box of 50 and never use the others anymore.  (We’ve also had some problems with the head straps on the Honeywell breaking off.)

 

If you want to learn more about mask quality, this guy who goes by @masknerd on social media is really great:  https://drive.google.com/drive/folders/1eE2BERAvRzs28kG87ft3a27FS9-gHvdC has his excel files from testing.

Even more on masks

Things I think I know from reading mask twitter (these are mostly PhDs who worked on N95 or aerosol studies etc. prior to the pandemic… I only link to mask nerd, but if you click on the people he retweets you end up going down a rabbithole of aerosol maskery) and watching masknerd on youtube.

• The best mask is the one you will wear consistently.
• Cloth masks are somewhat ok at protecting other people (WAY better than nothing), but not so great at protecting the wearer.
• Fit is more important than filtration.
• Filtration is still important.  Especially if you’re in places where not everyone is masked.
• Cloth masks, even ones with filters, fall down on filtration.  None of the cloth masks with filters I’ve seen tested have a filter that goes all the way to the edges (including enro :( ).
• Masks with head elastics tend to be easier to get a good fit with than masks with ear loops.
• Masks with ear loops may be easier to keep wearing the entire day, especially if you occasionally have to take it off to do things like eat or drink.
• KF94 last at least 40 hours without losing filtration.  N95 have been tested to last even longer.  One expert says that that with N95 the elastics die (or become too loose so you lose fit) before there’s filtration loss.
• Do NOT wash your paper mask with alcohol or sanitizer– that kills the electrostatic charge.  (Getting your mask wet seems to be ok, so don’t worry about rain.  Still, don’t wash them.)
• The best way to “clean” your mask is to wear it for up to 8 hours and then just set it aside for a couple of days.  Practically speaking, if your kids are going to school, this could operationalize as having 5 masks that they wear one school day a week for up to 5 weeks or until the fit no longer works, then swap out with another 5 masks.   My kids put their masks in a box next to the door when they come home.  I plan to put hash tallies on the masks in an unobtrusive place each weekend in order to keep track of how many uses they’ve had.  (YMMV if your kids get their masks literally dirty.)
• Different faces fit different masks.  Standard N95 don’t do as well with women’s faces or Asian faces on average compared to other groups (they weren’t tested on them!).
• It’s great if you can try a bunch of different masks in different sizes to find what works for you.  Also you may find that different masks work better in different situations (ex. A bifold Respokare works really well for my face shape, even though the measured filtration isn’t as impressive as the price-tag, but it is not breathable enough for an 8 hour day, where I prefer a medium Botn KF94 or Posh Large).
• 3M makes different shapes of N95.  We’re really liking their boat shape, though they’re not the prettiest masks (there’s visible staples).  You probably don’t want the hard body N95 for everyday use.
• KF94 have much better filtration than 94%.  The Korean government does a great job making sure that they don’t go below 94% which provides an incentive for companies to exceed that, and also makes it more difficult for fakes to come into the market (much easier to fake a KN95 because the Chinese government isn’t as careful).  KF94 are also a population-level mask, whereas the N95 standards are for occupations.
• Amazon sells a lot of counterfeit masks, especially KN95.  You’re best off going with a Korean mask from someplace like behealthyusa.net or 3M masks from your local hardware store or an authorized 3M dealer.  (I went on the 3M page and found places they authorized to get our 3M masks).
• Fogging glasses doesn’t necessarily mean that you have a bad nose fit.  On the one hand, if you have a bad nose fit, your glasses are likely to fog, especially if you have a good fit everywhere else.  BUT if you have a great fit everywhere, that water vapor may still come out of the top.  Masks are breathable.  It’s the electrostatic charge that’s doing the job with Covid, not a complete lack of holes in the paper.  Some masks will put non-breathable paper on the top of the mask to prevent fogged glasses, but most don’t.
• With a good mask and a good mask fit, you shouldn’t be able to smell perfumes, but you may still be able to smell things like cooking food.  Apparently this has something to do with what the smells travel on and how big the particles are.
• The tests experts recommend don’t tend to be smell tests — they tend to be feeling for air gaps tests.  They have different suggestions for how to test.  I’m not sure what is best.  Also, it’s ok for the mask to move out a little bit when you breathe out.
• Some experts say if you’re boosted and wearing a well-fitting N95/KF95/(genuine)KN95 you’re ok and unlikely to get sick, even with Omicron.  Other experts say, no, if you’re the only person wearing a mask, even if you’re boosted, all that does is increase the amount of time before you get an infection and decrease the viral load.  Medical professionals, they argue, are professionally fitted and have other protections when working with Covid positive patients.  But increasing time and decreasing viral load is a good thing!

Are these true?  I don’t know!  They disagree with things other non-experts have said in their round-ups (see:  Josh Marshall), but the general idea– wear N95/KF94/(genuine)KN95 instead of cloth or surgical masks, and get the best fitting of those that you’re willing to wear consistently– those are probably good.

Ask the grumpies: More on masks

Steph asks:

Have you tried the KF94s from [behealthyusa.net not sponsored]? I’ve got some flying coming up in the new year and am considering upgrading from my KN95s that I use for teaching.

YES. They sell the BOTN which are the top rated across KF94 both guys (Aaron Collins and Lloyd Armbrust) who do ratings and you can get 100 of them at $1/mask right now as a holiday clearance (or a smaller number for less money but more per mask).  At the most recent NBER health conference, I noted Amy Finklestein (a top health economist) was wearing a BOTN KF94 as her chosen mask.  I LOVE the KF94– it is a sea change from KN95 in terms of fit and comfort. They have this extremely clever yet simple method of tightening the ear loops and the boat-style is away from your face so it’s easier to breathe.  I no longer wear KN95 unless I have a cute (but terrible quality) redbubble mask to go over it that matches the day’s class topic for my Ms. Frizzle thing.

I also got some of the POSH holiday style ones which aren’t rated as highly as BOTN but are still very effective according to one of the guys who tests masks.

My friend with a small face really likes the child-sized Tiger masks they sell, which are highly rated by one of the two guys.

For flying and other places where I’m concerned I’ll be in an enclosed space with unmasked unvaccinated carriers in areas with high case rates I use the Respokare N95 from a different website which are insanely expensive (like $13/each, head straps, great foam nose piece) but I CANNOT SMELL MY HAND SANITIZER when wearing them. The BOTN KF94 generally mute the smell, but it’s still there.  (Aaron Collins is not that impressed with the respokare— he prefers the Botn.)

Ask the grumpies: Can we talk about masks?

Lisa asks:

Since you mentioned masks, can we talk about that for a minute? I’ll be teaching a class full of students tomorrow – they should be masked and I will be masked. I’ve been reading about which masks are “best” (for me and for my kids who are at school). But I feel like the “best” masks don’t work so well for a few reasons.

If I were to fly on an airplane or something, I’d wear a KN95. Best protection, fairly easy to wear. However, when I’m talking, the KN95s and surgical masks move all over on my face and I’m constantly adjusting them, so I can’t really wear either of those options to class. The Old Navy masks fit me really well and stay on well while I talk, so that’s what I’ll be wearing, even though cloth masks are not as efficient at filtering things out. The ON masks are triple layer, though, which is not nothing…

Same issue for my kids – the two oldest can wear KN95s although one of them prefers the ON masks. I feel like either is OK since they’re vaccinated and the vast majority of the school is masked as well (for now). The little one doesn’t have any KN95s that fit well (we’ve ordered a few to try), likes the ON masks pretty well, but is wearing some double layer minecraft character masks I got as a special back to school surprise (which is clearly my fault, I should have made them stick with the triple layer ON). I’m wondering how much of a difference it really makes. As long as the mask fits well and the kids will wear it, and as long as everyone is wearing a mask and the ventilation is good, I’m hoping our cloth masks are protective enough. If we were in the situation your DC1 is (few classmates masked or vaccinated), I’d go for as much protection as possible. But I’m hoping that with near-universal masking the stringency doesn’t have to be as high. What do people think?

I am not a medical professional and I don’t study the effects of masking or modern virus transmission.

From what I’ve read and from what natural scientist has said, the #1 thing (after will your kids keep them on) is fit.  Filtration particle size is a distant second after that.

If everyone else is masked, then yes, it is safer!  It is such a simple solution, and yet evil evil people have made this a political issue such that I will “get in trouble” if I ask my students to wear masks.  I had a really cute anonymous survey planned at the beginning of class where I was going to compare people who got Moderna to people who got Pfizer across another characteristic, but I have to scrap that because we got a lengthy email from general counsel about not asking people if they’ve been vaccinated, even anonymously.

DC1 likes cambridge masks and primalwear masks.  They are thick and hot and expensive.  DC2 is a HUGE fan of enro. They are light, washable, fit really well, and are cute(!) but they are likely sold out.  We have been unable to find KN95 that actually fit DC2, though that’s moot now that zie is homeschooling, at least until DC1 or I bring covid home. DC1 also likes the Old Navy masks, but they don’t fit completely around hir face–there’s gaps, so that’s out of the question for now.

The last two days at student orientation I’ve been rethinking my mask choices because so few of our students were masked (like 30% the first day and maybe 10% the second day). Day 1 I double masked with a crappy “Vote” mask and a KN95 construction style and it would just not stay put (though to be fair to n95maskco.com, I’m not sure if I used one of theirs or one of the KN95 from the grocery store– I had better luck double masking with them and a cloth mask back last February). So day 2 I double masked with a really nice (and very expensive!) disposable N95 (Respokare® NIOSH N95 Respirator Mask) that works way better. I’m trying to decide whether to steal one of DC1’s fancy masks or to just use N95 or to double mask with an N95 and a cute but useless redbubble mask. My initial plan of loosely and comfortably masking is completely out the window.

Double masking was hard on my ears last spring and I had some trouble keeping both sets on my ears at all times.  N95 are nice because they’re head straps, not ear straps, though they are incompatible with me wearing a pony tail.  DC1 has added the head straps to the ear straps on all hir Cambridge masks.  We’ve been doing a lot of experimentation.

Jenny F Scientist adds:

I did a post on this (http://naturalscientist.blogspot.com/2021/07/masks-yet-again.html) and the answer is… ??? Everyone wearing a mask is definitely more effective than any non-N95 mask you could wear (and even those, if the fit is not PERFECT, are generally no better than a surgical mask, no really, they fit test them for medical professionals annually with hoods and a bittering agent and really and truly the fit is no longer okay after 3-5 on/off cycles). If you look at Figure 5 there, the *source* wearing a surgical mask captures 90% of particles and the receiver also wearing one will capture another 50%(ish). And also, yes, fit, i.e. sealing, makes a difference (SMNat vs. SF data points; N95 with vaseline or without).

I have worn N95s and KN95s in both medical and scientific settings, everyone hates it and they are super uncomfortable and sweaty no matter what. I tried to wear a really fancy Cambridge Mask in the airport last week and I was so hot I nearly fainted and had to take it off. “Objectively the best but unwearable” is, as you say, perhaps not ideal.

Honestly the next best thing you can do in a classroom is more air exchanges: tape a 22″ square filter to a box fan, mask off the edges with cardboard if you want, and set it running in the doorway…. (like this but you can do it with one filter: https://www.texairfilters.com/how-to-improve-the-efficiency-of-the-box-fan-and-merv-13-filter-air-cleaner/)

SP says:

I’m interested in this topic. In the toddler classes mask use among kids was pretty spotty, but they seem to be more consistent in the preschool so we are trying to upgrade our masks. By the time I went to google to see what was recommended for kids (Enro, but probably not a fit for toddlers, and happy masks), they were completely sold out with months long wait list. OK, fine. I am starting with a better fitting set of masks with low cost, which is better than some of her others – but still shopping around for something I’m happier with.

On the flip side, it all feels a bit futile because LO is not yet 3, so even best case use seems to be marginally useful with a room full of little ones. (Teachers are masked/vaccinated too.) And I’m happy to take ANY margin I can get, I just don’t know how much difference the mask choice will make in the long run. And they also must remove masks for nap time (indoors, 1-2 hrs). But, this presumably is not going to go away any time soon, and her proper mask usage will likely improve over time, especially with comfortable/good masks.

Alice adds:

I tried to get a better quality of mask (happy masks, others) for my 5-year-old, and got too frustrated by the Not In Stock situations everywhere I looked. It doesn’t matter what’s best if you can’t get it anywhere. We’re still using basic cloth masks with a filter pocket, and I’m using the PM2.5 filters that you get from Amazon. She at least loves the patterns. (Space! Favorite colors!) Based on what I see at pick-up, she’s on the middle-to-high end of standard for her class. Everyone is wearing masks (thank goodness for the mandate), but there are definitely kids wearing single-layer no-pocket masks. They do all have them on, though.