April 15, 2020

PA Crafts Masks in Response to National PPE Shortages

By A. Kate MacDougall

In addition to continuing to treat patients and meet the challenges of the COVID-19 pandemic, Paige M. Goforth, PA-C, a physician assistant in hematology/oncology from Tennessee, is helping to tackle another important issue: the country’s dwindling supply masks for the general public utilization. 

The Centers for Disease Control and Prevention (CDC) now recommends wearing cloth face coverings in public settings where social distancing may be difficult to maintain—areas such as grocery stores or pharmacies. Many health-care facilities around the country are running low on supplies of surgical masks, which staff use to protect themselves as well as their immunocompromised patients during clinic visits. With the evidence that prefaced this new CDC recommendation, Goforth, a crafter by hobby, got to work. 

“So I started looking into different [sewing] patterns and decided to go for it!” Goforth said.

Goforth first researched medical agency websites, such as the CDC and National Institutes of Health, for tips on how to make the safest and most effective cloth masks. She cited the CDC’s Understand the Difference infographic as helpful in determining which type of mask or mask cover you need.

“The N95 mask is to protect the wearer…from things coming in,” she explained. But surgical masks “are designed to protect the person on the other side [from] what you may cough or sneeze out of the mask.”

In terms of materials, most of the research Goforth found suggests using tightly woven cotton as fabric for handmade masks. However, she explained that the SARS-CoV-2 virus measures at approximately 0.1 microns—small enough to pass through most fabrics and other barriers, even high-efficiency particulate air (HEPA) type filters, like those used in some air purifiers and vacuum cleaners, which filter 0.3 to 1.0 micron-sized particles.

“I wanted to make [these masks] as safe as possible,” she explained, so she chose to craft the surgical-type masks using two layers of tightly woven cotton and sew in a filter pocket where a piece of HEPA filter or other barrier material could fit. In the N95 respirator cover masks, she sewed two layers of non-woven interfacing—an inner construction material typically used to make a garment more rigid—in between two layers of tightly woven cotton, creating four layers of protection.

For the surgical-type masks, Goforth also suggests sewing in a piece of pipe cleaner in the area of the mask that goes over the nose to help close gaps between the skin and mask and make it easier for those who wear glasses. She also said that she sews an additional fabric binding over the pleats on the sides of the surgical masks to cover the gaps that can sometimes appear in that area.

“[These masks] are a necessity at this point,” Goforth said, noting that her state of Tennessee has not yet reached its peak in terms of confirmed COVID-19 infections, like much of the rest of the United States.

Read more from the APSHO Advance: Special COVID-19 Series