By Julia Mastroianni and Craig Takeuchi

Canadians should now be wearing three-layer masks, including a middle filter layer, according to new recommendations announced by chief public health officer Dr. Theresa Tam on November 3.

The recently-updated guidelines note that all non-medical face masks, whether homemade or purchased, should be made of at least three layers of “tightly woven material fabric” such as cotton or linen.

This is a change from previous federal guidelines, which previously recommended two layers for Canadians.

The World Health Organization has recommended three-layer masks since June. Tam said during the COVID-19 briefing in Ottawa that the decision to change Canada’s guidelines now was based on evolving research.

“The science of masks has really accelerated during this particular pandemic," she said. "So we’re just learning again as we go.”

The announcement comes amid continued surging numbers across Canada. In Ontario, the province reached a record high of 1,050 cases on November 10. British Columbia's new case count hit record highs three times this week, with today's 589 new cases as the highest. 

The recommended third layer should go in the middle of the mask between the two outer layers, and should be made of a filter-type fabric. The federal guidelines recommend non-woven polypropylene fabric, but they also mention other disposable filter options such as a coffee filter or folded paper towel.

Tam said the key too an effective mask is depends on the material, how the mask is made and how well it fits. The mask should completely cover the nose, mouth, and chin, fit securely, and not change shape after washing and drying.

Mask designers respond to new rules

Rory Lindo, co-owner of Damzels in this Dress in Toronto, started making face masks after she had to close down at the beginning of the pandemic.

At the time, even though public health advice only recommended two-layer masks, Lindo and her team made both two-layer and three-layer masks to sell.

“There was a demand for both," she says. "There’s many people who feel that their breathing is restricted in three layers. And then there are people who wanted that extra layer of protection.”

Now that the government is officially recommending three layers, Lindo says they’ll still continue to sell two-layer options.

“It’s going to be hard to get people to start with three layers,” she says. “I think people who have challenges breathing in two layers are going to be reluctant to wear a three-layer.”

Anna Banerji, a pediatric infectious disease specialist at the University of Toronto, says it’s important that people who are concerned about wearing a three-layer mask know that using their current masks is better than nothing.

“We don’t want people to be frustrated and say, ‘Well, I only have these masks and I don’t want to go out and get other masks’, and not wear their masks,” she says.

She says that for those who can’t find three-layer masks or don’t want to get rid of their current ones, there are other options.

“If someone wants to increase their safety, then they can take their mask and put a filter inside of it,” she says. “Just open up the seams and put something in, it’s pretty straightforward to do if you are comfortable with a bit of sewing.”

Danica Salajko, owner of Toronto swimwear company Bathing Belle, is considering doing the same with her current mask design. She began creating two-layer lycra face masks at the beginning of the pandemic based on the mask guidelines at the time. Since Tam’s recent announcement, she’s been thinking about how she’s going to update her current design.

“I’m going to try to build another layer," she explains. "I maybe might try putting something like a pocket for people who want to add their own filter.”

Salajko says she’s still going to finish selling off her current stock of two-layer masks, because she knows there will still be a demand for them and people might like having extras around the house. She notes that if she adds a new layer to her masks, she’ll likely have to increase mask prices by about a dollar.

Banerji says the added benefit of a third filter layer is that it can further prevent the transmission of smaller particles, though it’s a fine balance of too few layers and too many layers.

“Ten layers may be better than two layers, but a certain point, it becomes more difficult to breathe and it can be uncomfortable,” she says.

Surgical mask-making in Surrey

In other mask-making news, a Metro Vancouver startup will help ensure medical personal protective equipment will be available for Canadian healthcare workers as international demand continues to create competition for sources.

Eternity Medical Equipment announced today (November 6) that it will open a medical mask facility in Surrey this month to produce more medical-grade personal protective equipment within Canada.

The 13,000-square-foot facility plans to make up to 2.5 million masks each month and will specialize in making 95PFE respirators, which is Canada’s equivalent to the U.S.–based N95.

While most surgical masks are three-ply, these masks will be four-ply.

The company is awaiting certification from Health Canada and production is anticipated to begin in December.