The Necessity of Prohibiting the Masks With Exhalation Valve During Emerging Infections Like COVID-19

Abstract

The emerging pandemic of coronavirus disease-2019 (COVID-2019), without an effective treatment, challenges the capacity of the health care system in many countries. The vaccination program is still limited and not universally administered. Masks as one of the most effective means for source control are mandated. Different types of respirators are used by health care providers and others in the community including Filtering Facepieces, surgical masks, and cloth masks. However, concerns have risen about wearing a mask with a valve. The exhalation valve is a one-way port that allows the free outflow of the air and is preferred by some people due to lower expiratory flow resistance, and easier breathing. However, it is suggested that the mask’s valve result in the virus spread. The Centers for Disease Control and Prevention discouraged the use of masks with valve only in situations where a sterile environment is needed, and in suspected and affirmed cases, asymptomatic carriers, and close contacts.1 However, it seems that these recommendations are not enough in the way to control the pandemic. We discuss here 5 situations that the cases are infectious but unaware of their potential virus shedding while wearing a valved mask: