The Amazing Race 34, Episode 6

Amman (Jordan) - Toulouse (France) - Château de Beynac (France) - Château de Commargue (France) - Domme (France)

Face masks (“elastomeric respirators”) for safer travel

[On the Thalys high-speed train between Schiphol Airport and Brussels.]

As I noted last week, one team of contestants on The Amazing Race 34 was eliminated before the last episode because they tested positive for COVID-19. Since then, the remainder of the cast of the reality-TV travel show has more often, although not always, been shown wearing face masks when they are close to other people.

Viruses and bacteria are invisible to the naked eye, and it’s easy for the threat they pose to be “out of sight, out of mind”. As for real-world travellers, it sometimes takes having someone close to us test positive or get sick to remind us of the risks we are taking of infection and/or trip interruption if we resume travelling exactly the way we used to, before the COVID-19 pandemic.

COVID-19 testing is required — more strictly than in almost any other industry in the USA — by Hollywood TV and movie production protocols and union agreements. But masking, at least on camera on The Amazing Race 34, seems to have been left to cast members’ own judgment.

Scenes of racers (not to mention passers-by) on The Amazing Race, sometimes masked and sometimes not, are a helpful reminder that mask wearing is not a binary choice. Most travellers, like the racers, wear masks sometimes but not always. You can’t wear a mask while eating, for example, and sometimes it’s too cold to eat outdoors. There are different types of masks, as discussed further below, each with their own pros and cons.

We don’t have enough information to second-guess the racers’ choices. We don’t know which of them may be immunocompromised or otherwise vulnerable. We don’t know who is experiencing symptoms, without yet testing positive for COVID-19, of what might turn out to be either COVID-19 or a common cold, and is therefore taking extra care to reduce the risk they pose to others around them. I’m not a doctor, much less an infectious disease specialist.

Mask wearing is not a choice we can leave to governments, if we ever could. Like COVID-19 testing, decisions about mask wearing have largely been delegated to health authorities. Many people have worn masks when that was required, and have assumed that when masks aren’t required, they aren’t needed. That assumption is still being made by most people in some countries. I’ve gotten multiple reports recently from Germany, for example, that the continuing requirement for masks on trains and public transit vehicles in Germany is being respected, but that very few people are wearing masks in places where they aren’t required, even at crowded superspreader events like Oktoberfest.

With masks, like testing, no longer required even in contexts where they are clearly helpful in reducing the risks to ourselves and others, we have to take responsibility for making our own choices about what risks and risk-reduction measures to take. We might prefer that it were otherwise, but that’s the situation we face for the foreseeable future, possibly for the rest of our lives if COVID-19 and/or its mutations remain endemic and virulent.

Our choices are about reducing risk, not eliminating risk. We can no more avoid all risk-taking when we travel than if we stay home. Travel, like everything we do, is inherently risky, and many of the hazards of life are the same whether or not we travel.

To keep things in perspective, the greatest risk of death or serious injury to travellers still comes from car crashes. That calls into question the balance of risks in choosing, as the producers of this season of The Amazing Race have done, to have the racers travel by car rather than by train or bus.

During the AIDS pandemic, thinking and advice about risk-taking evolved from sexual abstinence to “safe sex” to “safer sex”. That conceptual framework of “harm reduction” is applicable today to travel: If we are travelling again in the COVID-endemic conditions “after the pandemic”, what can we do to practice “safer travel”, recognizing that there is no such thing (before, during, or after the COVID-19 pandemic) as “safe travel”?

Wearing a face mask when it isn’t incompatible with other activities, especially when we are in close, prolonged, and/or confined and poorly ventilated proximity to others, can make a significant contribution to reducing the risk of travel. I see no reason not to keep wearing a mask in these situations for the foreseeable future, even if there are activities for which I remove my mask.

This wouldn’t have been unusual in some countries, even before the COVID-19 pandemic. In Japan and China, among other places, it was already considered normal politeness to wear a mask in public whenever you had, or thought you might have, a cough, cold, or flu. I recall a flight from Shanghai to Tokyo, five years ago, on which half a dozen passengers on the plane with me were wearing surgical masks.

A “surgical mask” is the cheapest type of face mask, and significantly reduces the risk to yourself and others. Even with frequent testing, you probably won’t know that you are infected until after you are already infectious, so there is always some risk to others even if you feel fine.

A mask of the type labeled “N95” in the USA or “FFP2” in Europe is only a little more costly and provides much better protection than a surgical mask. Your mileage may vary, but I find some styles of N95/FFP2 masks more comfortable than surgical masks. Try to always carry a spare in case yours gets torn or too dirty or the strap breaks. A mask of this type is sometimes labelled as a “respirator”.

In the selfie at the top of this article, I’m wearing a third very different type of mask, an “elastomeric respirator”. This type of mask provides dramatically better protection, and for me substantially greater comfort, especially for prolonged wear such as on flights and train or bus rides, with some caveats and tradeoffs.

Elastomeric respirators were developed and are marketed primarily for protection against occupational and industrial hazards. They are commonly worn in welding, auto body, and paint shops and other settings in which people are exposed to dust or toxic aerosols. Designed for all-day wear, they are lighter and more comfortable than they appear.

Because they were originally designed to protect the wearer against ambient hazards (with interchangeable intake filters for dust, toxic chemicals, etc.), not to protect other people against the wearer, most elastomeric respirators were originally designed to filter only inhaled and not exhaled air, and have free-flowing unfiltered exhalation valves. But in response to the COVID-19 pandemic and shortages of N95 masks, some manufacturers began to offer models with exhalation as well as inhalation filters, or add-on retrofit exhalation filters. Respirators (masks) of this type are now being used for COVID-19 risk reduction by workers in some major medical facilities.

Paper or cloth masks, unless they have an unfiltered exhalation valve (which is easy to spot), filter the air you breathe out as well as the air you breathe in. But it’s harder to tell by inspection whether an elastomeric respirator has an exhalation filter or an unfiltered exhalation valve. For this reason, airline staff were trained not to allow them as long as masks were required on planes. But now that masks are no longer required, you are allowed to wear any mask you like, including these more-protective ones.

This type of mask/respirator was first recommended to me by my friend Sasha, a nurse who has worked with patients with infectious diseases from AIDS to COVID-19. From what I have read and as best I can tell as a non-expert, a respirator like this gives a substantially higher level of protection than any paper or cloth mask. I’ve gotten some strange looks, but fewer than I had feared. Airline and airport staff in particular have seen respirators like this before, especially on immunocompromised travellers.

Since getting vaccinated against COVID-19, I’ve worn this respirator to and from Europe and on a series of flights back and forth between San Francisco and Boston, including day flights and red-eyes, to visit an ailing older relative. Boston-San Francisco is the longest commonly flown airline route in the contiguous USA, with a flying time comparable to the shortest transatlantic flights to and from the USA, which are also to and from Boston. (Seattle-Miami is 20 air miles longer, but has far fewer nonstop flights and typically a slightly shorter flying time. When I returned from London last week with a stopover in Boston, the London-Boston and Boston-San Francisco flights each took almost exactly the same seven hours in the air. Boston-Lisbon and Boston-Dublin, both of which I’ve flown in the past, are even shorter than Boston-London.) I’ve also worn this respirator on Amtrak trains including overnight, buses from Chicago to Milwaukee and elsewhere, and a variety of European trains and mass transit vehicles.

This type of mask would also be a good choice for visits to other high COVID-risk crowded indoor spaces where you are engaging in spectator activities and don’t need to talk much or at all, such as theaters, concert halls, indoor sports arenas, museums, and tours of buildings.

Comfort is subjective and personal, but I’ve found my elastomeric respirator much more comfortable than an N95 mask, especially on a long flight or train or bus ride. It takes less effort to breathe in or out through an elastomeric respirator than through an N95 mask. An indication and a side benefit of the better filtration is how much it reduces ambient smells on planes, trains, buses, etc. (If you have allergies or other reactions to scents, it may also help reduce the risk of headaches or other side effects if you have to walk through the perfume section of the duty-free shops to get to your flight.) Because the elastomeric respirator retains more exhaled water droplets, my mouth, nose, and throat get less dried out on long flights. The straps go around my head without interfering with eyeglasses, hearing aids, etc. behind my ears the way many cloth or paper masks do.

A full beard like mine impairs the seal of any face mask, but even with a beard, my respirator fits much more closely and leaks much less air around the edges than any N95 or paper or cloth mask I have tried. A side benefit of less air leakage, better filtration including of water droplets, and channeling of exhaust downward is that my eyeglasses fog up much less with this type of respirator.

The largest drawback of an elastomeric respirator is that it makes it very difficult for others to hear or understand anything you say. I wouldn’t wear it in any situation in which conversation is needed or desired.

You can wear a cloth or paper mask through a TSA checkpoint, but checkpoint staff may make you remove an elastomeric respirator so that they can inspect it. To avoid having to take it off and having it handled and breathed into by unmasked checkpoint staff, and so that I can talk with the gate agent if necessary, I wait to swap my N95 mask for my elastomeric respirator until I am about to board the plane.

The filters for an elastomeric respirator are replaceable and made to collect large volumes of dust or other particles. If you are just using them for COVID-19 protection, not in a dusty environment, they will last almost indefinitely unless they get damaged or dirty. At most one spare pair of filters should suffice for travel, and takes up very little space or weight in your luggage.

With most models you need to buy the respirator, inhalation filters, and exhalation filter as separate items.

The elastomeric respirator I’ve been using seems to be the industrial respirator most often being used for COVID-19 protection, especially since the manufacturer introduced the optional add-on exhalation filter:

• 3M Model 6000 series respirator. Available in three face sizes (I’m using size medium.)
  • Model 6100 Small
  • Model 6200 Medium
  • Model 6300 Large
• 3M model 604 exhalation filter (You need one per mask.)
• 3M model 2091, P100 particulate (inhalation) filters (Sold by the pair; you need one pair per mask. Other interchangeable filters compatible with any of the masks above provide more or less particle filtration, less resistance to breathing, and/or additional reduction of ambient smells.)
• 3M Model 2291, P100 particulate (inhalation) filters (These were out of stock when I ordered my mask and filters, but I will probably try them if I need to order more filters. These cost only slightly more than the Model 2091 filters above, are made of a different material that has lower resistance to airflow, and are off-white rather than garish magenta in color.)

There are many online sources for these, but make sure they have all three elements in stock before you order. There have been intermittent supply chain issues with these, as with all personal protective equipment.

I got my respirator and filters online from R.S. Hughes, a large industrial equipment supplier. Delivery to my home in San Francisco took about a week:

• Respirator:
  • Size Small
  • Size Medium
  • Size Large
• Exhalation filter
• P100 particulate inhalation filters, 3M Model 2091
• P100 particulate inhalation filters, 3M Model 2291

(I have no interest in any of these products, manufacturers, or suppliers.)

The tasks assigned to the cast of The Amazing Race 34 in this week’s episode in France were all staged outdoors, and involved fairly little close contact with other people (and almost none with any aspect of contemporary life in France). The racers were flown from Amman to Toulouse on a chartered plane, and had to drive themselves from place to place. But what if can’t afford a private jet, and are travelling by public transport? Air filtration on planes is actually much better than in many other settings. A better mask seems to me more important on long-distance trains and buses, and most important on crowded city buses, subways, and streetcars.

Conventional wisdom has been that second-class seating on most European trains is more than comfortable enough for even an all-day ride (which I think is true), and that first class isn’t worth the additional cost (which hasn’t always been true, even before the pandemic).

These days tickets on most European trains are priced like airline tickets. At the last minute, and/or if a particular train is almost sold out, a ticket may cost five times as much as if you buy it a few months in advance, as soon as tickets for that train go on sale. Limited numbers of highly-discounted, nonrefundable, nonchangeable advance-purchase tickets are available in first as well second class.

If you are able to commit to your plans well in advance, the difference in price between first and second class may be minimal — often as little as EUR10 (US$10 at the current exchange rate) for a five-hour journey on a high-speed train. Most ordinary Europeans travelling on vacation or to visit friends and family, and even many business travellers, never even think to compare first-class prices, assuming (wrongly) that they will be too high to be of interest. On a route that wasn’t popular with expense-account business travellers, and when second class was therefore much more more heavily booked than first class, I’ve gotten a discounted first-class ticket for less than what one of the few remaining second-class tickets on the same train would have cost!

Typical second-class chair cars on European trains have two seats on each side of the aisle. Typical first-class cars have two seats on one side of the aisle, and one seat on the other, with both wider seats and wider aisles. With respect to the risk of COVID-19, it may be worth paying a little extra, especially if you are travelling by yourself, for the additional physical distancing of a solo seat in first class. First class cars are also generally quieter, less crowded, and unlikely to have standees in the aisle even on unreserved local routes.