COVID-19

By Chuan Hao (Alex) Chen (University of Pennsylvania)

Recently, I’ve been helping out with an initiative for making face shields, riveting pieces of laser-cut plastic together. Before I leave the house every day, I put on a cloth mask that my mom sewed and sent to me back in February. This was when the pandemic was “peaking” in the “Four Asian Tigers,” when my Taiwanese family was panicking but my American friends were just mildly concerned. Maybe it would be like SARS-CoV-1, burning out elsewhere before hitching a ride on an airborne human. That is no longer the case, and I try not to touch the mask once I have it on.

Photograph by Sharon McCutcheon on Unsplash

The volunteer site is located at the industrial zone of Philadelphia. To get to it, I cross a bridge meant primarily for automobiles, walk past Philadelphia’s enormous recycling warehouse, and wave at security guards wary of new volunteers coming by for their three-hour shifts. The innovation-incubator-type space we work in has a deconstructive twist on the modernist concrete aesthetic. Fluorescent lights arranged in “V’s” overhead illuminate our gloved hands as we, seated at modular mobile tables at least six feet apart, slip the rivet through holes punched in the plastic, place a washer on the other side, and use the rivet gun to “pop” a length of metal called a “mandrel” out. Sometimes the holes are too small, sometimes the mandrel snaps in half, and sometimes we run out of particular components and have to stop. Charity, the kind and energetic organizer who’s constantly on the phone with the suppliers, thanks us and tells us that more will arrive at 1 p.m. She’s not optimistic it will be on time.

Personal protective equipment (PPE) turns the mundane science of supply-chain logistics personal. It matters that we have enough PPE to keep alive the people who work to keep us alive. It also matters that we need to keep alive—and keep working—the people who make PPEs. But more stuff doesn’t translate into more protection. An incorrectly used mask or glove is like a dirty and sodden rag: it just smushes the virus further around. I learned this lesson when I was following health-care workers preparing for Ebola. The moment you are most likely to get contaminated is when you take the PPE off, when you are eager to shed the stuffy and sweaty jumpsuit and you feel a false sense of security because you are no longer with the sick patient. In your hurry, you accidentally touch the contaminated outside surface of your PPE, and voila.

Which surface matters. In a hospital or biological laboratory, the places where people talked about PPE before SARS-CoV-2 made them colloquial, the assumption was that you know if you are contaminated or pure. A scientist working with smallpox samples is assured that they don’t have smallpox, so the outsides of their gloves, touching the sample, have the job of keeping them protected. The same scientist also knows that they carry germs that can contaminate the pure smallpox sample that they are working with, so the inside surface protects the sample from the scientist’s germs. The same is true for an operation. The mask protects the surgeon and the patient, both with different germs, from cross-contaminating each other.

Photograph by Airman 1st Class Destinee Sweeney

Unfortunately, we volunteers don’t really know if we are contaminated or pure. When I grab a pair of gloves at the beginning of my shift, ostensibly to protect myself from potential viruses lurking in the innovation incubator, I wonder if I’m just smushing viruses all over the box. In surgeries, you use individual sterile glove packs numerically sized to fit your hands. You have to put them on in a certain way to not get your dirty hands on the outside surface, the side in contact with the patient’s insides. I know that the box of gloves is not sterile; I just hope that I haven’t contaminated it with the contagion that has consumed the global imagination.

We do our best. The volunteers all come wearing masks so we don’t breathe our own germs into the space. We queue a certain distance apart from one another as we wait for our assignments, though most of us do not have an astute sense of depth perception measured by the foot. The organizers wipe down the chairs and tables with bleach after each shift so we have clean tables to work on. Charity asks those of us with cloth masks if we want to put in a “filter,” a surgical mask. I didn’t want to contradict her, to say that “as soon as I take off my mask to put in the filter, I will have exposed the mask’s inner surface—ostensibly filled with my own respiratory contaminants—to everyone else.” I smile—hoping that the deepening crow’s feet around my eyes and the glint of my cornea would be sufficient to convey my thanks—and accept the gift of the mask.

The edges of PPE are important surfaces too. In fact, for the coveted N95 mask to work, they have to be fitted to one’s face. There can’t be any gaps between your face and the mask’s edge for contaminants to enter, so no beards are allowed. Right before you start clinical rotations in medical school, they line you up to get fitted. Once you put on an N95, they put a giant plastic bubble around your head and spritz a sweet-smelling vapor into the bubble. You only have the right fit when you can’t smell anything (so the fit test is not accurate if you are already congested). The face shields that we make are really just intended to stop droplets from splashing a health-care worker’s face during invasive procedures like intubating patients for ventilators. Miasmic viruses like SARS-CoV-2 can easily come around the shield’s edge and touch your face.

Traditionally, we talk mostly about the mask’s outside surface, the part legible to society’s gaze, the social skin.[1] Shanghai-born architect Duyi Han has rendered health-care workers in white PPE jumpsuits as angels,[2] a sartorial update to the white coat. Masks can signal care. Yet a mask’s outside surface can also be understood in negative ways. The CDC, thinking largely about filtration function, recommends wearing homemade cloth coverings outside. But in their recommendation, they neglect that police racially profile based on outer surface presentation, that some state laws made before the epidemic prohibit wearing face masks in public,[3] and that wearing “medical” masks in nonmedical setting invites suspicion. We are, for better or for worse, quite facile in recognizing the outside of the mask.

What I want to draw our attention to, instead, is the mask’s inner surface. This is the surface that we see when we pay attention to the topology of masks. Topology is the study of continuities, of tracing surfaces through time and space. At minimum, this entails examining the underside of masks, the inner surface covered with our respiratory traces. Topology focuses us on the edges, where things can seep in, where an errant finger bridges the divide between the inside and the outside. By looking at how surfaces connect, as opposed to nodes and networks, we see just how critical a topological understanding is for producing an effect like personal protection.

From my house to the innovation incubator to the hospital, my mom’s cloth masks, the ill-fitting gloves I wear, and the face shields I rivet come into contact with one another. Certain choreographies are essential to making sure that the clean side will never touch the dirty side, that the edges between my glove and the face shield will not intersect, forming a bridge for viral travel. Tracing topologies is another method for understanding chains and movements, one that produces new visions and affects.

Photograph by author

In a miasmic world where we can’t all get tested, we are like Schrodinger’s cat, simultaneously pure and contaminated. When I go make the face shields, I am equally concerned with getting others sick and with getting sick myself, including from the hundreds of respiratory viruses other than SARS-CoV-2. This also means that our relationship to the virus—protected, vulnerable, sick, healthy, prepared, unprepared—is multiple and constantly shifting, depending on where we travel in relation to the topology of the mask. Like a Möbius strip, there isn’t a clear inside or outside of the mask; we are simultaneously in front and behind.

Mary Douglas once said that things are not clean or dirty in of themselves.[4] Rather, dirt is “matter out of place.” This assumes that we know when something is in—or out of—place, and when it comes to SARS-CoV-2, we no longer really know. Sometimes we are in front, sometimes we are behind, and sometimes we are both in front and behind the mask. So I wonder: How might tracking such shifting spatial relations, the topologies of the mask, reveal new ways of thinking about purity, danger, and the virus?

NOTES
[1] Turner, Terence S. 1980. “The Social Skin.” In Not Work Alone: A Cross-Cultural View of Activities Superfluous to Survival, edited by Jeremy Cherfas and Roger Lewin, 112–140. London: Temple Smith.
[2] Feola, Josh. 2020. “‘Design Mutator’ Duyi Han Celebrates Hubei Medical Workers with Stunning Church Murals.” RADII, February 17.
[3] Taylor, Derrick Bryson. 2020. “For Black Men, Fear That Masks Will Invite Racial Profiling.” New York Times, April 14.
[4] Douglas, Mary. 1966. Purity and Danger: An Analysis of Concepts of Pollution and Taboo. London: Routledge.

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