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What Masks Tell Us About Medicine

ASEEM SHUKLA, HOST: As the coronavirus outbreak escalates across the US, hospitals are struggling to find enough masks and other protective equipment for their medical staff. Masks have been used since the 17th century to protect doctors and nurses from contracting the diseases they’re trying to treat. Ciara Long looks at how masks were first used and how their design has evolved with medical science. (00:19)

CIARA LONG, BYLINE: It’s a familiar pattern: a new disease starts to spread, and face masks start flying off the shelves.

CLIP 1: Cases of swine flu are popping up all across the country...

CLIP 2: We’re moving on to our swine flu coverage and schools shutting down, crowded hospitals and increase in the sales of masks…

CLIP 3: We are for sure seeing increased volumes of patients…

LONG: Since 2000, SARS, swine flu and the Ebola virus have all resulted in a run on face masks. The coronavirus shortages… are worse.

In late February, Health and Human Services Secretary Alex Azar said that the US needed 300 million face masks for health care workers.

That’s ten times as many as were available.

Zaki Azam, a first year medical resident at the Bronx Montefiore hospital, says that shortages mean staff are saving and reusing disposable masks for weeks at a time.

ZAKI AZAM: What we've been told by from hospital leadership is to sort of preserve our masks and try to keep it with us like it's gold.

LONG: The idea of using face masks to protect doctors dates back to the 1650s. Winston Black, teaches the history of medicine as at the University of Idaho.

WINSTON BLACK: During the actual Black Death of the 14th century, we start getting calls to purify the air with a smoke with sweet smells. So late 16th, early 17th century, we start getting doctors more and more, covering their face when they go to visit a plague patient.

LONG 4: Black says the first masks focused on the idea that the air was somehow contagious. Doctors wore floor-length leather coats, big leather hats and gloves. (00:10)

BLACK: That mask, it looks like a bird, terrifying crow or raven. So the idea here is the doctors entire body not just their mouth and nose but their pores, their eyes, their ears are protected from possible plague air.

LONG: The long, pointed noses of the masks were filled with sweet or bitter herbs and spices.

BLACK: Sweet or bitter smells will block out the bad air of plague.

LONG: No surprise, these masks weren’t that effective.

By the end of the 1800s, we had germ theory — the hypothesis that germs, not air, were responsible for the spread of disease. And with germ theory, came a new type of mask.

Amanda Mahoney is the chief curator at the Dittrick Museum of Medical History.

AMANDA MAHONEY: Some of these physicians that are desperately trying to slow down the rate of infection in military hospitals during the beginning of the 1918 flu outbreak, used gauze masks, which were very, very simple layers of cotton gauze from bandages that were sterile, placed over the patient's mouth.

LONG: Again, not that effective. Virus particles could filter through those gauze masks pretty easily.

But during the 1918 flu epidemic, medical professionals turned to respirators… which had been developed for use in coal mines and factories and to filter out air pollution. They fit more tightly around the face than masks and offer a higher level protection.

They remain among the essential tools that healthcare workers need to treat coronavirus patients today.

AZAM: You can't send an army into battle without giving them the protective armor that they need in order to help them succeed.

LONG: Zaki Azam, the first year medical resident at the Bronx Montefiore again.

AZAM: For us doctors, we see masks and other protective personal protective equipment as the armor that we need to sort of tackle this crisis at hand. And, you know, without that, it's almost, it's almost impossible for us to have a chance at succeeding.

LONG: He says hospitals are preparing to be inundated with sick patients. And if doctors and nurses can’t protect themselves from getting sick, there won’t be anyone to care for them.

For Columbia Radio News, I’m Ciara Long.

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