For this, our first-ever #ThrowbackThursday post, Dear Pandemic is pleased to present: every single thing we’ve ever posted about #masks (and a few things we haven’t posted before).
Q: Should I wear a mask?
A: Yes.
A thorough review of the evidence of physical distancing, face coverings, and eye coverings as prevention strategies for COVID-19 and similar coronaviruses (SARS and MERS) suggests that general population mask-wearing is effective to prevent disease transmission.
Across 29 studies, the use of N95 (or similar) respirators, disposable surgical face masks, and reusable cloth masks all reduced the risk of infection among people exposed to someone who had the disease.
The same study also found that the more distance you have between you and other people, the better–but less than 6 feet (1 meter, actually) was particularly high risk.
We also know a bit more about SARS-CoV-2 viral shedding and dynamics these days. Because the virus is primarily transmitted from person to person, in close contact, and through respiratory droplets, it makes sense to reduce the possibility of spewing droplets on another person. The mask then provides a barrier from the infected person so droplets are more likely to stay in the mask and also spare the other person from coming into contact with as many droplets.
So yes, you should wear a mask. CDC agrees.
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Q: How should I wear a mask correctly?
A: Your mask should fit snugly, cover your nose and mouth both, be secured with ties or ear loops.
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Q: What kind of mask? Cloth mask? Filters? Gaiter/homemade mask/surgical mask/N95 mask/stretchy designer mask like they have been wearing in Asia for decades????
A: Anything is better than nothing. For the general public, a good-fitting cloth mask made with two layers of tightly woven fabric is recommended.
Fabric and disposable surgical masks both offer some protection. Fabric masks should be made of a tightly woven fabric and fit well on the face.
Fit and comfort are important, since we are telling you to wear one a lot and a leaky mask is less effective. The mask should cover the nose and mouth. You should not touch the exterior of the mask. And you should change/remove the mask if it is soiled. This is tricky in the summer and for little ones, but we can do our best, especially when in crowded settings!
Homemade masks should have at least two layers of tightly woven fabric such as quilting cotton, bandana, high thread count sheets, etc. They should be constructed out of washable material, and laundered regularly.
A study tested various fabrics in a lab setting and found that a tightly woven quilting cotton in 2 layers provided some good reduction in droplets (that’s the formula we have seen in most of the DIY masks, and that’s fine). Silk also performed very well (for all that silk you have laying around), as did cotton-polyester blends.
The more layers the mask has, and the more tightly woven the fabric is, the better it will protect. Also, if the fit is very leaky, filtration goes down by as much as 60%. So a tight fit is probably more important than the specific material.
We could find no specific evidence on a gaiter or buff, but CDC does endorse a cotton bandanna folded in half. Based on the principles we’re dealing with, if you elect to wear a gaiter or buff, choose one with a tightly woven fabric and make sure it has a good fit around the nose. You might want to double it up to provide two layers.
As for filters, some people have been making homemade fabric masks with a pocket to insert an extra layer such as a paper towel or a blue shop towel. This would provide a little more protection still.
N95 and other healthcare-grade masks are still in a critical shortage for healthcare providers, and in a high-exposure environment, such as what a healthcare provider faces when caring for a COVID-19 patient, a cloth mask is less effective and should not substitute for professional grade personal protective equipment.
So, unless you are in a high-risk setting (such as providing care for a sick patient), we’re still not ready to say you should be wearing N95’s.
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Q: Does wearing a fabric mask protect me, or just others?
A: Wearing a fabric mask does provide you with some protection! And it also protects other people.
That same article in the Lancet from above found that wearers of cloth masks had reduced risk of infection when exposed to a sick person, and CDC cites a number of studies to come to the same conclusion.
Our previous post on this topic is here.
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Q: Do I STILL need to wear a mask if I am more than 6’ away from other people, and/or outside?
A: Yes, you should still wear it if you are with other people, even if they’re more than 6 feet away, and even if you are outside. This protection is *additive*–you will be better protected if you do more of the things. Being outside and physical distancing and mask wearing are all options to protect yourself and those around you, and the more of them you do, the better protected you are. They are not substitutes.
DP post on outdoor environments
And DP post on the SMART strategies to protect yourself and others while you go about your days (spoiler alert! The M is for MASK.)
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Q: Is a mask good enough if 6 feet of physical distance cannot be maintained?
A: Both would be better, but if 6 feet is not possible then the mask will still reduce your risk some.
We cannot recommend being in close contact with someone without masks at this point in the pandemic, PARTICULARLY if there is a lot of disease circulating in your area!
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Q: Should kids wear masks?
A: Yes, kids over age 2 should wear masks according to the CDC, but they will need your help to learn to wear them reliably.
For children 2-12, it could be difficult to wear a mask properly and therefore, may require practice and adult supervision (otherwise it is not effective and may be better to remove).
Here’s our previous post on encouraging your young one to wear a mask.
And a video explaining why & how to do it, for kids!
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Q: Are face shields good substitutes for masks?
A: No, but they’re better than nothing and very useful in some situations.
A face shield does offer some protection but is not as good as a mask. CDC says so, and here’s our previous post about it.
However we understand that for some situations, a mask is very limiting (for example, if you’re communicating with someone who reads lips). A face shield is better than nothing at all. ________________________________________________
Q: Someone went past me on the bike path/jogging/walking my dog and they were not wearing a mask. Should I freak out?
A: No, you should not freak out.
This kind of momentary exposure is very low risk. It’s just too short, and also outside–which means there’s more air for any particles you might have walked into to disperse quickly.
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Q: Will a mask suffocate me?
A: No. Unless you are an astronaut.
But seriously, there are a few people who should not wear masks: infants, people with disabilities and communication challenges that make mask wearing difficult, people who have trouble breathing such as with COPD, and people who are unconscious.
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Q: How can I keep my mask from fogging up my glasses?
A: Try a better fit on the nose, or tucking it into the bottom of your glasses.
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Q: Is there a polite way to tell other people to put on a mask?
A: We haven’t covered this one yet, but there are some great tips in this article from NPR’s Goats and Soda including:
* Choose your battles. If it seems like it will turn into a hopeless fight, maybe try some “defensive driving”– put your own mask on and keep your distance.
* Shaming and scare tactics do not work.
* Try a gentle nudge, for example saying “Wearing a mask protects us all!”
* And finally, set a good example by wearing one yourself.
We can add to that list of suggestions that it’s always a good idea to use “I” statements and questions when you’re entering rough waters. For example, “I am wearing my mask because cases are going up in our community, did you see the recent numbers?”
And finally, Lindsey’s 4th Law: always lead with empathy.
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Q: I heard that in countries where mask wearing is common, there was basically no pandemic. Is that true?
A: Not exactly. There are a lot of differences in settings around the world to take into account, and certainly the practice of mask wearing by the general public is one of them. But there have been a couple of real clickbait-y news articles and viral twitter threads making this claim a bit more forcefully than science can support.
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Q: Why has the mask landscape shifted so much? The public health messaging has been terribly confusing from the start.
A: We agree, it really has been confusing. A lot has changed in the last three months, and we are not just talking about how you plan your kids’ birthday parties! Here’s a 3-month old post where we were already trying to grapple with the rapidly shifting landscape on face coverings.
But at this point we are pretty clear on this much: You should wear a fabric mask in addition to maintaining 6 feet of physical distance when at all possible.
Science will continue to evolve. This takes some patience and understanding. Stick with us.
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You’re welcome.
