Mask up, breathe easy

Friday is World Anatomy Day, and as the pandemic continues Associate Professor Quentin Fogg shares the anatomical basis of breathing – with and without a mask. Plus, five steps to get more comfortable wearing one.

Not liking a mask? Who does! Finding them uncomfortable? Doesn’t everyone? The thing is these are not grounds for exemption.

Science shows face coverings are saving lives during the coronavirus pandemic, and with the number of COVID-19 cases surging in Victoria, compulsory mask-wearing will be here for some time yet to help keep people safe.

The vast majority of those who find breathing difficult while wearing a mask have no underlying medical issue. So, if you’re tolerance for masks is waning, this insight from Quentin Fogg, Associate Professor in Clinical Anatomy at the School of Biomedical Sciences, might help you stay sane – and safe.

Explain the basic anatomy of breathing?

Breathing is largely passive and unconscious. We can choose to control it, but most of the time we don’t.

It works like this: your upper airways filter and humidify air but have also evolved to be paths of least resistance to and from the lungs. This means, there is little to no control over what the air does in your upper airways once it’s in. Your chest volume is the key driver of respiration. The diaphragm subtly impacts your chest shape internally, which changes the chest volume and therefore chest pressure. This drives air in and out at a fairly constant rate.

Why is the path of least resistance concept important during COVID times?

If you block one entrance – your mouth – but leave another open – your nose – the open path will exchange greater volumes of air at a greater rate. This is determined by the volume or pressure of your chest cavity. So, wearing a mask with your nose sticking out is about the worst thing you can do. By doing this, you draw larger volumes of air into your nose,  which increases your risk of COVID-19 infection. Then, you blow more air out increasing the risk to others.

Wearing a mask around your chin is also bad news. Your upper airways warm and humidify air. The warm, moist air that you exhale is blown into the mask making it more warm and moist. Although it may not be moist to touch, this increased moisture makes it stickier for moisture droplets in the air – the main airborne transporters of COVID-19. So, your mask is potentially becoming laced with infectious droplets and increasing the risk to you, and if you get infected, to others. Even if those infected droplets don’t infect you, you can mobilise them when you put your mask back on, especially those lying on the outside of your mask.

Remember, your mask is only effective when it covers your nose and mouth. When not worn, it is best placed in your pocket or around your wrist, but never around your chin or neck.

How do I stop my glasses misting up? 

You need to fit the top of the mask closely to your nose and cheeks or rest the underside of the glasses on the mask. Surgical masks have a wire in the top so that you can pinch the mask across the bridge of your nose; this keeps it close to your cheeks. You can even twist the ear loops before they go around your ears, giving a tighter fit.

How do I make breathing feel easier when wearing a mask?

Commercially available masks do not restrict your breathing during normal activities, but that doesn’t mean you don’t feel confident in your ability to breathe comfortably while wearing one. Try following these simple steps to stay calm, comfortable and – most importantly – safe when wearing a mask:

  1. Find something you like doing that keeps you engaged and is relaxing.
  2. Make yourself comfortable, put on your mask and get ready to start your activity.
  3. Take a few quiet, gentle, steady breaths (not big, deep ones) and relax as much as you can.
  4. Start your activity and try to lose yourself in it so that you forget about the mask – don’t adjust it, just ignore it. Once you’re fully engaged in the activity, the mask will no longer be an issue.
  5. Do this a few times, over several days, to become comfortable wearing your mask.

What about people with exemptions?

Some people have genuine needs that prevent them from wearing a mask all the time. This could range from medical to communication needs. It is important to note that these needs don’t prevent you from being infected or from infecting others. Consult with your health care provider to find the best solution for you that will minimise risk of COVID-19 infection to you and others but will also allow you to function.

Want to know more? A/Prof Fogg, President of Australian and New Zealand Association of Clinical Anatomists, wrote a chapter on lungs in the 42nd edition of Gray’s Anatomy.