As we creep closer to cold and flu season, the number of COVID-19 cases continues to climb across the country. At the time of publication, more than 5 million Americans have been diagnosed with the respiratory illness caused by the novel coronavirus, while more than 160,000 have died. Experts warn that things will likely get worse before they get better.
In addition to frequently washing your hands, maintaining a six-foot distance from others, and cleaning high-touch surfaces, one of the simplest things you can do to protect those around you from infection is wear a face mask or cloth covering.
But the public health messaging around face masks has had a confusing timeline, especially in the United States. When COVID-19 first started to spread, public health officials said that face masks would not help prevent the spread of the virus. U.S. Surgeon General Jerome Adams even went as far as to tweet in late February that people should “stop buying face masks.”
But Adams, the Centers for Disease Control and Prevention (CDC), and other major medical organizations changed their stance in early April. Now, the CDC recommends that everyone wear a cloth face mask in public when social distancing isn’t possible. (Medical grade masks should still be reserved for healthcare workers.) “Cloth face coverings may help prevent people who have COVID-19 from spreading the virus to others,” the CDC states online. “Cloth face coverings are most likely to reduce the spread of COVID-19 when they are widely used by people in public settings.”
Despite the widespread recommendations to state-mandated laws to wear masks, many people are still refusing to do it—and that’s a huge mistake. Below, infectious disease doctors break down what you should know about face masks and COVID-19.
Can wearing a face mask really reduce the spread of COVID-19?
While doctors had mixed opinions in the past, the data is now very clear. “Face masks can help prevent the spread of COVID-19,” says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine.
The reasoning is simple. Respiratory illnesses, including COVID-19, can spread from an infected person to others through the air after coughing, sneezing, and talking or by touching a contaminated surface and then touching your mouth, nose, or eyes prior to hand washing.
If you wear a face mask, you can prevent your droplets from hitting the face or mouth of another person before they drop to the ground, says infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security. That’s why a community effort is so crucial. When you wear a mask, you’re protecting others. When those nearby wear a mask, they are protecting you.
One of the most notable demonstrations of this is a case report released by the CDC of two hair stylists in Springfield, Missouri. Both were infected with COVID-19, but the stylists and the 139 clients they saw all wore masks—and no one contracted the virus. “Adherence to the community’s and company’s face-covering policy likely mitigated spread of SARS-CoV-2,” the report concluded.
Another study, this one published in the journal Physics of Fluids, tracked “coughs” and “sneezes” (using a smoke machine) out of a mannequin head, and used a laser to detect droplets. For the study, a team of researchers from Florida Atlantic University placed different types of cloth face masks on the mannequin and then tracked how many respiratory droplets from the mannequin’s coughs and sneezes got through the masks, as well as how far they traveled.
The researchers found that well-fitted face masks with multiple layers of quilting fabric and cone-style masks were the most effective. Droplets only traveled about 8 inches with the cone-style masks, and 2.5 inches with a quilted mask.
For society to “return to normal,” a majority of the population needs to wear a mask until we have a viable vaccine, explains Richard Watkins, M.D., an infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University. “If not, we are likely headed towards another lockdown.”
Does the type of face mask make a difference?
Dr. Schaffner says an N95 respirator, which is “much thicker” than a surgical mask, tends to be the most effective at filtering out particles. However, they can be very difficult to breathe in, especially over extended periods of time. A surgical mask is still a great option, he adds, but both of these medical-grade options should be reserved for healthcare professionals who truly need them in high-risk settings.
That brings us to cloth face masks, which the CDC and World Health Organization (WHO) recommend for the general public to wear when social distancing is not possible. The WHO released guidance on cloth face masks in June, recommending that people use masks made up of at least three layers. According to the WHO, those layers should include:
An inner, absorbent layer made of a material like cotton
A middle filtering or barrier layer made of a non-woven material like polypropylene
An outer, non-absorbent layer made of polyester or a polyester blend
The WHO also recommends avoiding masks made of stretchy material because they’re too porous, as well as masks made of silk or gauze. (Learn how to make, clean, and properly wear your face mask here.)
What else can you do to protect yourself and others from COVID-19?
To minimize your exposure to a respiratory illness, take the proper precautions:
Wash your hands often with soap and water for at least 20 seconds.
Use a hand sanitizer that contains at least 60% alcohol if you’re in pinch.
Do not touch your eyes, nose, and mouth with unwashed hands.
Avoid close contact with people who are sick.
Maintain a six-foot distance from people outside of your household.
To avoid spreading a respiratory illness, be sure to do the following:
Talk to your doctor if you experience COVID-19 symptoms.
Stay home when you are sick.
Avoid taking public transportation, ride-sharing, or taxis if you feel sick.
Always cover your cough or sneeze with a tissue.
Clean and disinfect frequently touched objects and surfaces.
Do not share personal items—like dishes, drinking glasses, cups, eating utensils, towels, or bedding—with other people.
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