COVID-19 Pandemic Inspired Design – An Empirical Study on Maskeeper’s User Experience and Design Ergonomics

Design Needs Arising from the New Normal

Wearing a face mask when going out is becoming the new norm as a result of the pandemic. It is now widely accepted as an essential part of public health measures to suppress COVID-19 transmission and save lives. COVID-19 is highly infectious where its main transmission route is via the small droplets ejected from the infected person’s mouth or nose when they cough, sneeze, or even speak and breathe heavily. There is a growing body of evidence that the virus is capable to spread via airborne transmission through aerosol [2, 3, 4, 5]. A significant proportion of COVID-19 patients do not show any symptoms. These asymptomatic and pre-symptomatic patients pose a significant threat to disease control, as they are infectious but unnoticeable by people close to them [6, 7, 8]. Mask-wearing not only protects the wearers from the infectious disease but also serves as an effective measure of source control as it can reduce the possibility of infected patients unknowingly infecting others [9, 10, 11, 12]. Recent studies evaluating the community-wide impact of mask-wearing suggest that if the practice is synergized with other non- pharmaceutical measures such as social distancing, proper hand hygiene and avoiding poorly ventilated spaces, it could significantly mitigate community transmission and reduce hospitalizations and deaths [11, 13, 14]. Based on the understanding of the benefits of mask-wearing and the experience of Severe Acute Respiratory Syndrome (SARS) in 2003, Hong Kong citizens have completely bought in the concept of using masks to save lives. Hong Kong, an Asian metropolitan city with a population of over 7.4 Million, was one of the first cities in the world to enforce the mandatory use of face masks in both indoor and outdoor public places as a strict COVID-19 measure.

In contrast with the citizens’ resistance and scepticism against the use of face masks in other regions [15], Hong Kong citizens showed enthusiastic support for the use of face masks as a means to protect lives. With the widely accepted practice of mask-wearing in public since the beginning of the pandemic, many issues related to the daily usage, storage, user experience and design ergonomics of masks have been discussed. Various anti-COVID-19 products and accessories emerged in the first quarter of 2020, ranging from lift button pressing tool to pocket-sized hand sanitisers. Out of these designs, Maskeeper is one that adjuncts the use of facial masks.

Although there is a fundamental shift in public sentiment to embrace mask wearing since the 2003 SARS epidemic, little design innovation was put into thinking about how to store and keep the masks from cross- contamination when they are not in use. Although medical masks should be of single-use only, it is rarely the case in the COVID-19 pandemic, especially during the serious shortage of mask at the start of the outbreak. The severe supply chain disruption of medical supplies in 2020 and the prolonged compulsory requirement of mask wearing have made the public change their presumption resignedly. The shortage of face masks has prompted users to seek ways to minimize cross-contamination of their face coverings for avoiding unnecessary replacement. This paper examines the innovative product design called Maskeeper that was invented and patented in the early phase of the pandemic in Hong Kong. Through analyzing the user experience survey data to investigate its usability, this paper aims to identify key attributes that affect the adoption and subsequent use of the Maskeeper, and get insights into the evaluation and potential areas of improvement of its product design.

Mask usage Gained Acceptance in HK Since SARS 2003

This research selects Hong Kong as the study area for the reason that this city is well experienced in the fight against respiratory epidemics. Hong Kong citizens have learnt a painful yet valuable lesson from the 2003 SARS outbreak, where there were over 1637 cases identified and 299 lives lost in this metropolis. Therefore, the public response to the eruption of COVID-19 in 2020 was quick with hypervigilance [16, 17]. The exceptional compliance of Hong Kong people with mask-wearing has its root in the collective trauma of SARS [18, 19]. As early as January 2020, Hong Kong people have started wearing face masks after a few early reports of the once mysterious viral pneumonia spotted in Wuhan. Besides the calls and advice from medical professionals, mask- wearing has been etched into the psyche of the Hong Kong community. The highly visible face masks worn by citizens during an epidemic has been perceived as a potent symbol of solidarity and altruism of the Hong Kong people against the invisible pathogens, whenever during SARS, H1N1 Avian Flu or COVID-19 [10, 20, 21, 22, 23]. While WHO and health officials of many countries had been having no consensus on whether mask-wearing was an efficacious protective measure at the early phase of the pandemic, Hong Kong people put their faith in this protective shield which once helped the city to contain the spread of SARS epidemic [24, 25, 26, 27].

Several research studies showed that there was a very substantial change in voluntary mask-wearing behaviour in Hong Kong before and after the outbreak. According to a survey conducted from late March to early April 2020 in Hong Kong, mask-wearing increased from 11.3% before the epidemic to 97.4% after the COVID-19 outbreak [28], consistent with the findings of another study which reported that 74.5%, 97.5% and 98.8% of respondents wore a mask when going out during the survey period of Jan 20-23, Feb 11-14 and March 10-13, 2020 respectively [24]. Another survey also reported that 75.1% of respondents wore masks as a personal preventive measure against the outbreak [17], albeit it is lower than the previous survey which might be because of different sampling methods. An observational study of 10,211 pedestrians in several regions across Hong Kong between Feb 1-29 further substantiates the astounding compliance with mask-wearing among Hong Kong people – during the reporting period, 94.8% wore masks of which 83.7% wore disposable surgical masks [27]. The same study, which includes data of an online survey in progress before its release in April 2020, shows that about 94.1% of respondents believed that mass mask-wearing could avert transmission in the community. Moreover, it reveals an interesting fact that 76.3% of respondents had to reuse their face masks when the supply was tight and the price of medical masks skyrocketed in Hong Kong in the first quarter of 2020.

From the onset of the COVID-19 pandemic, it had been difficult to reach a global consensus over the efficacy of face mask-wearing to reduce the transmission of this highly contagious respiratory disease. Governments, health bodies, and scientists worldwide were holding conflicting stances over public mask-wearing [29, 30, 31] while many countries were being hard hit by the first or even second waves of coronavirus. There is a stark cultural divide on mask-wearing [20]. YouGov COVID-19 Behavior Changes Tracker shows that while mask-wearing has been widely supported by the public among the Asian countries as their new normal under the threat of COVID-19, Americas and European countries are less ready to embrace this preventive measure. With the advancing knowledge by a wealth of laboratory studies and randomized control trials on the efficacy of face mask- wearing [31], governments and health bodies have been gradually reconciling their views, and able to give more coherent advice, thus help to boost their citizen compliance with mask-wearing. Many western countries that had been lukewarm in the adoption of universal face-covering, for example, most states in the United States, the United Kingdom and Germany, have made mask-wearing in public compulsory. Face masks will continue to play a prominent role in curbing the spread of the disease in the next phase of the pandemic when countries start lifting lockdown and citizens resume most daily activities. Therefore, the practice of mask wearing would stay for a considerate period under the new normal.

Conceptual Design

The Maskeeper was the result of a collaborative design between two product designers Maurice Kwok and Steve Yeung of INNOSPHERE, a product design consultancy based in Hong Kong that specialises in the design of a range of consumer products with social impact. Their idea to design a handy-to-carry mask holder originated from an urgent need to find a way to reuse the mask before and after a short meal in January 2020. At that time, there was a gap in the market, as people could not find suitable products for the temporary storage of masks when they have to take them off on some occasions. Some people used tissue paper or envelopes to keep their masks, however, these interim solutions could not provide enough protection from moisture, dirt and germs. The practice also produces extra infectious wastes and adds a burden to frontline workers of the catering industry.

Identifying the pain points of the mask wearers that resulted from the lack of temporary storage for their masks during intervals, designers moved on to ideate the design of a mask holder through quick prototyping. Evolving around the ergonomic exploration of the design development of the Maskeeper, several design foci have to be considered and carefully balanced. The design has to reach several goals to maximise its usability. First, the mask holder should consider users ergonomics and be small enough for keeping in a convenient location such as a purse or a shirt pocket. Second, it should enable users to store their mask easily to prevent cross-contamination in the process. Third, its design has to be user-centric – simple, intuitive and easy to use by kids to elders with a positive user experience. The design spans from the refinement of the origami fold, material exploration, cost factors and control of the manufacturing process.

The design development of the Maskeeper has relied heavily on prototyping to brainstorm, test and validate new ideas, which closely resembled the Design Thinking methodology developed by IDEO. The design team has brainstormed over 20 ideas. Advancing the design concept via prototyping helps designers to validate their ideas quickly. By using paper and other materials to make several rough mock-ups that concretize the basic features of the design, these abstract concepts and ideas could be tested substantially (Figures 2 & 3). For instance, when the early prototype was tested against user behaviours, a fresh problem was revealed: the dangling ear loops outside the main compartment of the mask holder affected its performance, as users complained the floppy strips would easily attract dirt while they were hanging loosely from the mask holder. The team then worked further to improve the design and solved the problem by utilising the ear loops, which had been an obstacle to the storage solution, as an elastic closure to keep the origami fold intact and add value to the design (Figure 4). By relying heavily on prototyping to advance the iterative design development, designers used only two days to finalise the design concept.

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Design embodiment–materials selection and control of technique

Amidst the serious supply chain disruption and shutdown of factories in China in the first half of 2020, the design team aimed to launch the Maskeeper to the Hong Kong community as soon as possible to help the fight against COVID-19. Therefore, they addressed the materials selection and the manufacturing processes early on in the product design process. The team identified a set of material selection criteria while testing the prototypes:

• Durable, resistant to tear and water
• Resistant to fatigue so that it is not easily broken or cracked from repeated bent
• Suitable for injection moulding
• Non-toxic
• Resistant to chemicals, especially have to be impervious to alcohol-based disinfectant
• Readily available
• Low cost
• Light in weight
• With a smooth surface that would not scratch the surface of the surgical mask
• Recyclable
• Allows print on the surface Although paper is a convenient material for building working prototypes fast to test the origami folding, it fails to fulfil the design requirements of the Maskeeper. Different types of thermoplastics that have been widely used in product packaging were considered early on in the design process, including Polyethylene Terephthalate (PET or PETE or Polyester), High-Density Polyethylene (HDPE), Polyvinyl Chloride (PVC), Low-Density Polyethylene (LDPE) and Polypropylene (PP). Most of these synthetic polymers posed various challenges such as foldability and endurance of the folds. Designers have chosen PP as material for mass production as it can satisfactorily fulfil the material selection criteria as listed above. PP is non-toxic and is widely used for tableware and utensils. It has high resistance to fatigue referring to its outstanding mechanical property to withstand “fold and unfold” over hundred times, therefore it is durable for multiple uses. It is impermeable to water and with very good resistance to many aggressive chemicals. It can endure 75% isopropyl alcohol, which is a very popular disinfectant against COVID-19 and is widely used by people to clean the surface of daily items. Furthermore, it can be UV printed with a variety of patterns and graphics. The PP used by INNOSPHERE for the production of Maskeeper is lab- approved and complies with EN71-3 safety directives and BPA free.

The PP Maskeeper was originally planned to be mass- produced by injection moulding but the design team had to rely on the CNC laser cut machine available locally for the mass production of the first batch of products during that critical period of serious supply chain disruption. Applying laser cut to PP requires a very skilful technique to avoid wrapping of the sheet or burn marks on the surrounding cut edge surfaces. On the other hand, there are still many considerations on the thickness of the PP sheet for making the Maskeeper. Early trials proved that thick materials are very difficult to fold and too bulky to put in the pocket. Several prototypes have shown that a slight reduction in the material thickness could achieve higher efficiency in the cost and increase the foldability of the Maskeeper. By testing PP sheets of different thickness, 0.2 mm thick PP material was proven to be optimum and the next phase was to produce a high fidelity prototype by laser cutting. The technique is the result of a combination of design trials and multiple testing. The team calibrated the laser-cutting beam carefully in search of an appropriate frequency that could minimise the sheet wrapping from the cutting process. Meanwhile, they also constructed a special supporting platform to elevate the PP sheet slightly during laser cut, as it could make more space available for heat diffusion. The treatment helps to mitigate the chance of leaving visible burn marks on the PP surface. A cleaner cutting edge enhances the overall finishing and delivers a better user experience of the final product.

Another challenge to embody the design is to decide the optimal depth of the scoring of the fold. The ideal depth of the groove should allow users to fold the Maskeeper easily, but at the same time, be durable enough to withstand repeated folding. Maskeeper with folds of an optimal scoring depth is important not only for a better user experience; it also helps to improve the sustainability of the product as it can lower the defect rate during mass production, thus saving material and energy for every item produced on average. Through trials, the team has successfully cut the defect rate by improving the precision of scoring, thus making the mass production economically viable under the straining manufacturing conditions. The product was sold in the market in March 2020 after applying for a design patent and over 10,000 were sold within the first two months. With the positive response and success in sales, this research aimed to use a survey questionnaire to analyse the various identified parameters related to user experience and the ergonomics of the design of this first generation of Maskeeper.

Participants’ General Background and Mask- Wearing Behaviours

The questionnaire was divided into multiple sections. General background questions on gender, age and daily mask-wearing behaviours were asked. The statistics are summarized in Table 1.

Gender: There are more female participants compared to male participants in this study. Age group: All the survey participants are adults with age above 18, while the age groups are widely spread, lower to 18-25 years, upper to above 55 years. Since the survey was conducted on the university campus, more than 50% of the respondents belong to the 18-25 age group naturally. Most frequently used mask type. The disposable surgical mask takes the dominant lead as the most frequently used mask type. 96.78% of the participants use it as the main protective equipment against the outbreak of COVID-19. The remaining respondents (3.2%) choose other types of masks, such as cloth masks and N95/cup-shape respirators. Average number of masks used per day. Excluding invalid or non-numeric responses, the average number of masks used per day among the survey participants is 1.13. The number is only slightly more than one (mask) per day, which means during the day when people have to take off their masks (e.g., eating, drinking, etc.), they normally would not replace it with a new one. Instead, they would have to find someplace to store the mask temporarily and reuse it later.

Evaluation of Maskeepers’ Performance– Four Selected Design Factors

Table 2 shows the user evaluation of the four identified parameters attributed to the design of Maskeeper: namely material durability, user-friendliness, sustainability and emotional design. By analysing the research results, future improvements and adjustments can be deduced from the findings to refine the design of the next generation of Maskeeper.

It is observed that the Maskeeper has received overall positive users’ feedbacks, illustrating a means greater than 3 (neutral) in all the attributes. Among the four attributes, user-friendliness received the highest rating (avg. rating: 4.13), followed by material durability (avg. rating: 3.88) as participants were asked to bend and fold multiple times during the test period to ensure that the product can withstand the excessive wear and tear. This indicates that users are generally satisfied with the functional performance of the product. The majority of the participants agreed that the Maskeeper has multiple essential design quality - it is light-weighted, easy to fit into bags or pockets. The users’ instructions with graphical aids on the packaging are easy to follow.

As for the evaluation of materials, it is a two-fold analysis. On one hand, the Maskeeper is made of polypropylene (PP) plastics, which is not an environmentally friendly material as it is non-biodegradable. However, it is very resilient in multiple usages and has strong agility in the aspects of material quality and durability and therefore was given a relatively higher rating after the product trial. Most of the users do not find too much difficulty in cleaning the surface of the Maskeeper. Besides, other attributes such as sustainability and emotional design, which are not direct functional requirements and more subjective, have a relatively lower rating, and greater variance (standard deviations).

Descriptive Statistics of Explanatory and Response Variables

Table 2 is not only the user evaluation of the Maskeeper but also the descriptive statistics of explanatory variables in the regression models. Each attribute under the four different aspects is taken into account. The only response variable, usage frequency, indicates the user preference on the Maskeeper. Its descriptive statistics are shown in below Table 3.