Accountable Healthcare - Coronavirus and Face Masks: Everything You Need to Know Right Now
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November 19, 2020

Coronavirus and Face Masks: Everything You Need to Know Right Now

Think back to mid-March, when face masks weren't yet part of our new daily routines — in fact, top medical experts were advising everyday Americans not to wear masks because SARS-CoV-2, the respiratory virus that leads to a COVID-19 diagnosis, was new to the medical community and there was a limited supply of personal protective equipment (PPE) for frontline workers. Federal recommendations encouraging Americans to wear masks didn't come until April 3. Now, as researchers learn facts about COVID-19 every day, we've adjusted to a new reality where a face mask is an essential tool to move about our days safely. 

This guide — produced with input from Good Housekeeping InstituteTextile Director Lexie Sachs and a panel of infectious disease doctors and academics assembled by Good Housekeeping — will help you protect your family, friends and community as we all continue to do our part to stem the spread of coronavirus this winter.

Should I wear a mask for coronavirus safety?

It's a loaded question that you may have debated with loved ones and even strangers over the last six months, and the evidence required to answer it was slow to emerge at first. Despite earlier recommendations due to a national shortage of PPE for essential workers, the medical community has since discovered overwhelming evidence that suggests COVID-19 is largely spread in spaces with limited airflow and ventilation due to its viral nature as a respiratory illness. 

So, yes, you should wear a face mask to do your part to prevent the spread of COVID-19. Unless you have a pre-existing respiratory or heart condition, you should wear a mask in public spaces, especially when maintaining social distance between yourself and strangers isn't possible. Experts at the Centers for Disease Control and Prevention have established that much of the initial COVID-19 outbreak was traced back to individuals who were asymptomatic, unknowingly spreading the disease because they were unaware they were sick in the first place.

Does wearing a mask protect you from coronavirus? 

Another hot topic due to some misinformation and confusion: Masks do not always directly keep you safe from coming into contact with infectious airborne particles. N95 masks and other surgical respirators may be able to effectively filter the air you're breathing due to a tight seal around the face, but single-use medical masks and cloth-based masks that are being sold online are not designed to do so, says Robert Amler, M.D., the dean of the school of health sciences and practices at New York Medical College. They are designed to keep others around you safe by catching potentially infectious airborne virus particles that you've exhaled.

New evidence shared by the CDC builds on previously published research in The Lancet journal which suggests face masks may prevent you from breathing in infectious particles. Cloth-based masks may be able to provide "filtration for personal protection," CDC officials say, by shielding your nose and mouth from infectious droplets around you. The Lancet's research suggests that the risk of becoming sick via infectious airborne particles drops to about 3% if you stand away from others with a mask on, and the risk drops even further if it's a 6-foot berth or more.

The CDC's updated stance on the role of masks come after a growing number of studies demonstrate that masks can prevent others from becoming sick when in close proximity to an infected individual. One example comes from research that found two infected hair stylists serviced more than 60 clients who were likely saved from becoming sick due to the fact that they wore masks during their appointments. 

How much does a mask protect you from coronavirus? 

The primary reasoning for wearing a face mask or covering is to protect others around you, but some aspects of a face mask may provide added protection when used correctly. In terms of PPE, nothing is superior to an N95 mask, which filters out both larger and smaller particles in the air. Surgical masks, the kinds that you may buy from a medical supply retailer, provide protection from nearby splashes and sprays in hospital settings. But according to officials at the Arizona-based Mayo Clinic, these surgical masks may also filter larger infectious particles when you inhale. 

Nearly all cloth-based face masks on the market are made from tightly woven cotton, but CDC officials shared limited evidence that suggests certain materials may be better at blocking droplets. One is silk, which may be superior at repelling moist droplets, despite being much more delicate than cotton. The other is polypropylene, which may generate a static charge on its surfaces that may capture particles entirely.

If anything is clear, it's that the tighter the weave of the mask's material, the better. "Multiple layers of cloth with higher thread counts have demonstrated superior performance compared to single layers of cloth with lower thread counts," CDC officials shared in an update, adding, "in some cases, filtering nearly 50% of fine particles less than 1 micron."

How to wear a face mask properly?

We assembled a panel of leading infectious disease experts to provide the step-by-step guide below. The biggest takeaway here is ensuring your mask covers your mouth AND your nose, says Rodney Rohde, Ph.D., the associate dean for research for the College of Health Professions at Texas State University. Leaving your nose exposed means there's a chance that you can still spew infectious droplets into the space around you, even if you mostly breathe through your mouth.

  1. Place any straps around your ears, or tie behind your head's crown and the nape of the neck to secure mask to face.
  2. Cover your entire nose and mouth. Carefully pull and stretch the mask to adjust it around these areas. 
  3. Be sure to tuck the mask beneath your chin if possible, as this prevents shifting.

How to clean a face mask properly?

With the help of Good Housekeeping Institute Cleaning Lab Director Carolyn Forté, we include the CDC's cleaning recommendations below. 

  1. How to disinfect masks: You should only disinfect cloth-based reusable masks, not single-use medical masks. You'll need a fresh DIY bleach solution that allows you to entirely disinfect masks by hand. Prepare a bleach solution with 4 teaspoons of household bleach per quart of room temperature water; allow your mask to soak for at least five minutes before you rinse it with cold water.
  2. How to clean reusable cloth masks: Forté says face masks can be routinely washed with hot water in a regular cycle in your washing machine, and tumble dried on high heat. More delicate masks should be washed by hand with soap, scrubbed for at least 20 seconds with hot water before being dried. 
  3. How to clean surgical masks: If you've purchased a medical-grade face mask, these items are often designed for a single use only — and disinfecting this material at home isn't easy. Gonzalo Bearman, M.D., a hospital epidemiologist at VCU Health and the chair of the Division of Infectious Diseases at Virginia Commonwealth University, says you should not reuse these masks. If you must, place it in a dry paper bag to completely dry out for a few days to a full week, and be sure to wash your hands before handling it again. There's a chance that residual germs are still on the outside of the mask, but allowing it to dry may reduce viability for these germs in the long run. 

How can I avoid foggy glasses while wearing a face mask? 

If you wear glasses, you've no doubt noticed that warm breath seeps out from the top of a face mask and creates condensation on your lenses. Jason Brinton, M.D., a St. Louis-based ophthalmologist and founder of Brinton Vision, says you'll need to troubleshoot the fit of your mask in order to stop all the fogginess. Your glasses should sit atop your medical mask to secure it into place against your nose. Make sure you're using the embedded metal strip to secure the mask; or, conversely, add a pipe cleaner or twist tie to your DIY mask to help direct your breath through and not out of the top of your mask. Medical tape can also help keep things tight along your cheeks and jawbone if necessary.A last resort is to use a commercial anti-fog wipe or spray designed to keep your lenses clear — you'll need to use this each time you don a mask.

How long should I wear my face mask?

There's not a universal answer to this question: "A mask should be worn outside of your home when physical distancing is not possible," Rohde advises. But that's only true if you're not letting your mask become contaminated. If you've handled it with unclean hands or it's become entirely saturated due to your breathing or environmental conditions, then it's time for you to take it off and put on a different one. Why? Wet masks will cling to airborne debris and may draw in the particles we're trying to avoid in the first place. 

A mask is recommended if you need to leave your home to run errands, but if you plan to be outside the entire day, you may have to bring a spare to replace it with (and only do so after you've washed your hands). In addition to those who have breathing issues that prevent them from wearing masks, essential workers with access to N95 masks should be mindful that prolonged use may inhibit your oxygen intake at some point. "N95 or higher medical grade masks have a much higher filtration component, which can make it difficult over time to wear them long term," Rohde says. 

When should I wear a face mask? 

The short answer: Anytime that you are unable to maintain social distance between you and the people around you. And it's a good idea to wear it indoors when the ventilation is questionable and/or the room is crowded. Those living in highly populated communities can especially help stem the spread of COVID-19 by wearing a mask in most public spaces. Some cities, counties, or entire states may require you to wear a face covering of some kind while public, and the CDC still maintains similar recommendations.

Wearing a mask isn't a substitute for proper social distancing among strangers outside of the home, but can further reduce risk in places like: 

  • Supermarkets
  • Post offices
  • Pharmacies
  • Clinics and hospitals 
  • Big-box retailers, megastores, and other retailers
  • Banks
  • Laundromats
  • And more...

How to wear a face mask while exercising:

Whether you're running or biking outside or working out inside a gym, theoretically, you should be wearing a mask if other people will be around you. If you have a pre-existing condition, you should consult a doctor before you try exercising with a mask on — in the end, it may be necessary for you to stay home and work out instead, so that you may do so without having to cover your nose and mouth. Even the fittest people may feel that they can't perform workouts at full capacity due to the mask or covering, and you should expect to feel tired sooner than you normally would. "Nothing replaces the importance of hand hygiene and being careful to not touch your face, your mask, or rub your eyes while working out — or any time for that matter," Rohde says. Because you'll be breathing heavily, you'll want to use a mask that is comfortable for you (not one that you'll be constantly adjusting), and bring a spare in case it becomes saturated. Hopefully, you'll keep your gym sessions to an essential basis only (30 minutes is optical), and be able to get more cardio by heading outside into an area that won't put you within six feet of others.

Is it unhealthy to wear a face mask?

For most people, wearing a clean face mask after handling it with washed hands is perfectly acceptable. The only individuals who shouldn't be wearing a mask without consulting their doctors first are those with pre-existing cardiovascular and respiratory issues. "Most recommendations point to the individuals who have underlying conditions to take extra caution when exercising or doing other long-term work with a face mask on," Rohde explains. People who are experiencing conditions such as, but not limited to, the following should discuss mask use with their provider: 

Is it unhealthy to wear a face mask?

For most people, wearing a clean face mask after handling it with washed hands is perfectly acceptable. The only individuals who shouldn't be wearing a mask without consulting their doctors first are those with pre-existing cardiovascular and respiratory issues. "Most recommendations point to the individuals who have underlying conditions to take extra caution when exercising or doing other long-term work with a face mask on," Rohde explains. People who are experiencing conditions such as, but not limited to, the following should discuss mask use with their provider: 

  • Asthma
  • Chronic obstructive pulmonary disorder (COPD)
  • Bronchitis
  • Cystic Fibrosis
  • Pulmonary Fibrosis

Can I reuse my face mask?

If you've purchased or made a cloth-based face mask or covering, you can launder it regularly in your home. You should use it as long as its elasticity is intact, allowing you to keep the cloth tucked securely around your nose, cheeks, and chin. You shouldn't use a cloth face mask again unless it has been laundered since it was first worn, as it can accumulate germs on both its exterior and interior surfaces while in use out of your home. Dr. Bearman says the same rules do not apply to surgical-grade medical masks. While healthcare professionals across the nation have been forced to reuse N95 respirators and medical masks due to low supplies, they're highly trained in best practices to keep risk of cross contamination low, disinfecting them after each shift. Medical masks available to consumers aren't designed to be used more than once, so in the long run, you'd be better off securing cloth-based masks or coverings instead.

The best materials you can use for DIY face masks:

Sachs has delved into up-to-date research to make recommendations for masks designated for yourself, as well as masks you make to donate to hospitals. When making no-sew options at home, however, Sachs recommends that you use tightly woven 100% cotton fabric. You can use items like bed sheets, woven shirts, curtains, or even bandanas (a very common option) to make masks. A heavier cotton woven fabric such as denim works well to catch particles as well, but you may find it harder to breathe through. Lighter materials like t-shirts can sufficiently cover your face, but be aware: It's a knit material, Sachs explains, so using a covering fashioned from a t-shirt could cause the material to stretch, which may result in visible holes since knits are designed to pull apart by nature.

How to sew a face mask:

The Good Housekeeping Institute Textiles Lab collaborated with medical professionals, sewing experts, and fabric suppliers to create a comprehensive guide to sewing medical face masks at home. You'll need to source the best fabric available as well as a non-woven interface to filter particles (on the fly, you may be able to use coffee filters or even purchase pre-made filters on Amazon). You'll also need elastics or ties to secure to the face and a metal piece to snugly fit it around your nose.

Peruse our official sewing guide — complete with a custom sewing pattern you can print at home. You can also follow along with a video and step-by-step instructions from Amanda Perna, a fashion designer and Project Runway alum who has pivoted to sewing face masks since the pandemic began.

How to make a no-sew face mask:

Can't sew? No worries! You'll need to source many of the same materials to create a DIY face mask; a metal tab to secure the mask below your eyes, as well as materials to create ties or loops to secure the mask to your face. Just like a sewn face mask, your no-sew mask is made safer by including a non-woven material to filter airborne particles; our step-by-step guide recommends securing a coffee filter to use inside of a bandana. You'll find our no-sew face mask is accessible to all: Our illustrated guide contains step-by-step instructions with a video detailing the process from Amanda Perna as well.

Where to buy face masks online:

More and more retailers are working to provide cloth-based face masks manufactured with the CDC's recommendations in mind. We've put together numerous shopping guides accessible below, but wherever you choose to shop, but sure to look for indication that the retailer has manufactured their mask according to CDC guidance. Certain woven cotton fabrics are more lightweight and breathable than others, which are options you can look for when shopping for masks in warmer months and climates. Sachs says masks made with cotton poplin are being touted by manufacturers as "lightweight" and breathable compared to other models. If you're planning to make your own mask, try using a woven percale bed sheet in place of sateen options, and use multiple layers (between two and three). Use a non-woven layer for the middle layer to make it easier to draw in a breath. "The randomly oriented fibers of non-woven fabrics can help filter the air between you and the mask," Sachs says. Kids will need to wear masks in public as well, but only if they, too, don't struggle with pre-existing conditions; the CDC also states that anyone under the age of 2 shouldn't wear a face mask. Making a face mask for a child is similar to making one for yourself — you'll need to adapt dimensions — and retailers have also pivoted to provide shoppers with kid-friendly mask options. Check out our shopping guides below for expert-approved options.

Article By: Zee Krstic