Improving Facemask Safety

Prof. Fischer directs the Advanced Light Imaging and Spectroscopy facility at Duke University, which develops and builds cutting-edge optical microscopes. He received his Ph.D. in Physics from The University of Texas at Austin in 2001. After graduation he joined Bell Labs/Agere Systems, then worked in Radiology at the University of Pennsylvania. In 2005 he moved to Duke University where he explores novel optical techniques for molecular three-dimensional imaging in highly complex materials in the areas of biomedicine, materials science, and cultural heritage science. The senior project team at Duke also includes Warren S. Warren, James B. Duke Professor of Chemistry, Physics, Radiology, and Biomedical Engineering, and Eric Westman, Associate Professor of Medicine.

Mandates for public mask use during the COVID-19 pandemic, worsened by a global shortage of commercial supplies, have led to widespread use of untested homemade masks and mask alternatives, particularly in less-developed countries.  It is likely that getting control over the pandemic will require such masks worldwide, and require that they work. We have shown that a simple optical method (using an inexpensive laser and a cellphone camera) can evaluate real-world performance of face masks during speech.  Some mask types perform well, while others offer very little protection.  Our proposed device will be easy to use, inexpensive, and can be replicated in the community to demonstrate the need to wear face masks to curb the ongoing pandemic. This device could dramatically enhance the acceptance of wearing face masks, push local development of effective designs, help people learn how to wear them effectively, and reduce transmission for current and future pandemics.

As of early July, the current COVID-19 pandemic has infected more than 12 million people and resulted in a death toll of over 500,000, globally – and these are only the confirmed cases. To curb further rise, the WHO recommends a combination of social distancing, frequent hand washing, and wearing a mask. Widespread mask use will be needed worldwide even when a vaccine is developed; FDA has announced it will approve vaccines that are 50% effective, and nobody knows either how long immunity lasts or how rapidly the virus will mutate.  Supply shortages and disposable mask cost have led to widespread use of homemade masks and mask alternatives, some of which have been shown (by our team, among others) to be ineffective, or even worse, counterproductive. Resistance to mask use is a multi-faceted problem, but a major contributor is that it is not immediately obvious to a non-expert why a mask benefits an individual and the broader public. We want to provide a tool to test and demonstrate the effectiveness of face coverings in the community, resulting not only in an increase of mask use, but also use of masks that actually work.

We will develop an inexpensive, robust, and easy-to-use device to demonstrate and measure the effectiveness of face coverings to reduce expelled droplets during speaking, coughing, or sneezing. The measurement principle is based on recording light scattering from small droplets and aerosols. An operator wears a face mask and speaks into the direction of an expanded laser beam inside a dark enclosure. Droplets that propagate through the laser beam scatter light that is recorded with a video camera. A simple computer algorithm is used to count the droplets in the video. The required hardware for these measurements is commonly available; suitable lasers and optical components can be purchased for less than $200, and a standard cell phone camera can serve as the video camera. The experimental setup is simple and can easily be built and operated by non-experts. We plan to make the design and code available to the public, offer kits for assembly by the user, or supply pre-assembled devices. This device will be able to demonstrate and measure the effectiveness of masks, mask alternatives, or face shields. It will be able to characterize mask materials, designs, fit performance, longevity, and reusability.

We are currently in a global pandemic, so to a first approximation, this project will impact everyone. However, in this crisis, underserved communities are disproportionately affected. A contributing factor to this inequality is the limited availability of masks, since limited stock affects low income and remote populations first. The same population is also the most vulnerable, often working long hours with few to little options for social distancing. Another factor is the lack of awareness of the necessity for wearing masks or information on which masks are effective to curb the spread. We collaborate with medical and community workers to understand the socioeconomic driving forces and we will promote awareness and testing efforts in (and for) these communities.

This project primarily addresses the needs of underserved communities, but is also related to the other dimensions. COVID-19 clearly is a global pandemic and raising awareness for mask use and improving their quality standards can contribute greatly to curb the spread. In addition, this project not only measures the effectiveness of masks, but also demonstrates the action of masks in a manner that is clear and relatable to everyone. While reading scientific publications describing clinical trials is second nature to researchers, the public is more likely swayed to don a mask by seeing its effect with their own eyes.

This project has a very practical origin. An outreach organization distributing face masks in underserved communities was planning to purchase masks in bulk for distribution. However, they had no information on how well the masks would perform in real life. As director of a developmental microscopy center, I was approached as to whether I would be able to develop a measurement apparatus. Based on a technique that researchers at the NIH used to visualize droplets emitted during speech, we developed a testing approach for face masks. We demonstrated the use of this lab setup on the mask under consideration, along with a variety of commonly available masks and mask alternatives. We were surprised to find that when speaking through the masks, some masks did not perform nearly as well as expected. In fact, one mask not only was ineffective, it seemed to make matters worse by breaking down big droplets into several smaller ones, which then have an easier time being carried away in the air. The mask under consideration did not perform well and as a result, the order was cancelled, preventing many people from wearing ineffective masks.

As a researcher in an academic setting, I have never worked on a project that could have such a global, important, and immediate impact. In contrast to medical personnel, I can rarely say that my work saves lives. Addressing this global pandemic is extremely important and urgent - and I want to help! I strongly believe that the current pandemic is going to be with us for some time to come, and even when brought under control, will recur in some form in the future. The focus on underserved communities is especially important to me because of strong family ties to a minority group. I see first-hand the challenges these communities face and feel privileged to be in a position to affect a permanent positive change.

In my function as director of a developmental microscopy facility, I develop tools and techniques in basic spectroscopy and imaging in order to apply them in a wide range of fields, such as biology, medicine, materials science, and even cultural heritage. In this facility, I not only develop new techniques and instrumentation, but also make them available to the community. This proposed project makes use of several of my areas of expertise, such as optics, microscopy, and biomedical science.  My training and experience in several fields (physics, engineering, radiology, and chemistry) has prepared me well for such a highly interdisciplinary project. I have further teamed up with medical, engineering, and community outreach experts, who will help me with the planning and realization of this project.

The other senior team members (Warren and Westman) are medical school faculty members, and Westman is a practicing MD.  Between us, we nicely cover the clinical, engineering, and physics components of the work required to make this method practical and accessible.

This project addressed a time-critical need (evaluating mask performance prior to a very large community purchase) at a time when access to University labs and facilities was highly restricted due to the lockdown.  Thus, I could not access university resources (like the machine shop) or place orders for materials and supplies. I set up the prototype mask testing station with tools and materials I had available in the lab and at home. The required equipment I temporarily removed from another setup, knowing fully well that restoring it to working order will take me many days (much longer than the 30 minutes it took to remove it). Because of occupancy and social distancing restrictions, I also could not request help from staff or other researchers. Since the testing setup required two persons for operation, I recruited volunteer help from a household member. Despite these obstacles, we were able to provide solid mask data in time to prevent the purchase and use of ineffective masks.

In my role as Research faculty, I have no teaching obligation – despite that fact I routinely volunteer to teach courses and I mentor post-doctoral researchers, graduate, undergraduate, and high school students. Teaching and mentoring interactions are not only extremely rewarding, but also solidify my own knowledge as a scientist and a mentor. My voluntary commitment to teaching and mentoring is not limited to my academic life, but also extends into my private life. As a long-time martial arts practitioner, I study and teach different styles of martial arts at all skill and age levels. My team members Warren and Westman have held University leadership positions for over a decade as well.

The innovative aspect of my project is the application of a very simple optical tool to a pressing global problem. This simple tool has the potential to have a widespread and immediate impact at a very low cost.

COVID-19 has changed the world greatly in the last few months, and these changes will last for many years.  Pinning hopes for a return to “normalcy” on a vaccine is very likely naïve; it is unclear how long antibodies last (and the most recent evidence is not encouraging), the vaccine will certainly not be completely effective, and the possibility remains that COVID-19, like HIV, will not remain stable long enough for a vaccine to be effective.  Thus, COVID-19 will not be defeated with anything less than a global effort, spanning all socioeconomic classes.  Mask use is going to be a part of that solution, but a poor mask or poor fit is worse than nothing, in part because it gives a false sense of security.

Our work has shown that good masks don’t need to be expensive or complex, but they need to reflect cultural preferences if they are going to be worn.  That means the best solutions are going to be local, even home-made.  The devices we can build empower communities, and allow them to positively impact their own health future.

We are not doing this for financial gain; Duke has announced that all COVID-related patents will be available royalty free until 2023.  We have already altered one major community purchase decision for the better.

Our work has already informed mask choices at Duke University, and altered a local community purchase of thousands of masks.

My one-year plan is to develop the design for a mask testing device, perform proof-of-principle experiments, build a prototype, and start disseminating the design plans to the community. During the next five years, I intend to scale up dissemination by working with partner entities (mostly non-profit institutions) to design an inexpensive kit and distribute assembled devices to the broader community.

To build a device prototype in the first year, I have the required expertise in research and development, but require a work force. Given my position at the university, I plan to work with and at the same time train and mentor students during this project. To build the next-generation device that is small, robust, and inexpensive, and to scale up the dissemination to the broader community, I require expertise in design, manufacturing, marketing, and legal expertise.

For the prototype R&D, I have the expertise and the majority of the required infrastructure. For this period, I am requesting support for student and staff salaries, minor equipment, and supplies. To ensure that the project addresses medically relevant questions I will continue to collaborate with experts in the Duke University Medical Center. For the manufacturing and dissemination stage, I will partner with experts within Duke University (e.g. the Office of Licensing and Ventures) and outside organizations.

Duke University Pratt School of Engineering (engineering support for R&D), Duke Trinity School for Arts & Sciences (basic research aspects of the project), Duke University Medical Center (medical aspects of the project), and Cover Durham (community outreach).

Our business model is disruptive.  We intend to help community groups make a usable mask evaluation system.

We have requested internal funding from Duke University, which would be very limited and will get us through staffing for a few months; we are also looking at Federal funding streams, but they are slow.  The funding level anticipated for the Elevate Prize would be absolutely transformative.

The expected expenses for the initial project period (18 months) are primarily salaries for students and staff. I anticipate a 50% effort level for three graduate students, three undergraduate students, and one post-doctoral researcher. I am currently supported through other funding and only request one summer month salary during this period. The total anticipated salary cost (including fringe benefits, tuition remission, and facilities and administrative cost) is about $322,000. The prototype also requires the acquisition of minor equipment and supplies (for example, lasers, lenses, custom optics and mounts, safety materials, construction materials, mechanical components, air filters, and computer acquisition and storage hardware). We anticipate materials and supplies to amount to $115,000 (incl. F&A). For validation of the prototype we will require the purchase of a particle sizer at an estimated cost of $56,000. Finally, the design of the next generation device will require external contract support for mechanical (parts design and manufacturing), electronics (PCB design and manufacturing), and programming (software licensing, consulting) tasks. We estimate consulting expenditures at about $80,000 (incl. F&A). The total estimated expenses for the 18-month project period amount to $573,000.

In the first stage of the project, The Elevate Prize can help by providing the required salary support for the students and staff and by providing funds for minor equipment, material and supplies, and contracting cost (mechanical, electrical, and programming work for prototyping). For final product design and scaling up dissemination, The Elevate Prize can provide expertise and networking opportunities for design, manufacturing, marketing, and legal aspects of the project. Finally, through the Elevate Prize network I anticipate having access to a non-profit donor network.