What you should know about Wearing a Face Mask?

Since the onset of the COVID-19 pandemic, we now have compelling evidence that community mask-wearing is both an effective way to reduce the spread of infection and protect an individual from exposure to infection. Therefore, the U.S. Centers for Disease Control (CDC) continues to recommend that people wear masks or cloth face coverings to prevent the spread of COVID-19.

We know the COVID-19 virus is spread primarily through droplets formed when you cough, sneeze, talk or sing. These droplets can travel in the air and get into the eyes, nose, or mouth of other people. A mask prevents your droplets from spreading to others. It is a good idea to wear a mask even if you don't feel sick, so you prevent your potentially infected respiratory droplets from spreading to others. It is estimated that at least 50% of the virus transmission occurs from persons who never develop symptoms from COVID-19 or those in the early phase of their illness before symptoms occur.

Wearing a face mask offers some protection to you as well by filtering out droplets that may contain the virus when you breathe in air. How well a mask can filter infected droplets depends on the design of the mask, how well it fits, and the materials used.

Regardless of the type of mask you use, it should securely cover your mouth and nose, fit snugly along the sides of your face and be large enough to fit underneath your chin. When you remove your used mask or face covering, don't touch your eyes, nose, and mouth. Wash your hands immediately after removing it.

Several types of masks are available and being marketed to the public. A respirator, also known as an N-95 mask, provides better protection than a surgical mask, which provides better protection than a cloth mask. However, all masks, when used correctly, significantly reduce the spread of COVID-19 infection by greatly reducing the exposure of bystanders to infected air droplets. Community and individual protection are greatest when everyone is wearing a mask and wearing them correctly.

Recommended types of masks or face coverings

Respirators: Respirators are the most protective mask for a wearer. It shields against breathing in small droplets from in the air. There are many types of respirators, with the N-95 mask being the most common type used to protect healthcare workers. The N means it is not “oil resistant” if contaminated with an oil type substance and the “95” means that it filters out 95% of particles that are over 3 microns in size. Three microns is one ten-thousandth of an inch. Respirators, unlike disposable surgical masks and cloth masks, form a seal around the face. It should be fitted to the individual. Because of their effectiveness, N-95 masks should be used by frontline workers exposed to COVID-19 infected people or those who have a high likelihood of being exposed to people infected with COVID-19.

Due to the high demand for the N-95 mask for healthcare workers, the Food and Drug Administration (FDA) has allowed through emergency use authorization (EUA) orders respirators meeting specifications set by other countries. Since the specifications from other countries are not the same as the U.S., the FDA reviewed the respirators for those that most closely met the U.S. criteria. The respirators approved for use in the U.S. are listed in “Appendix A” on the FDA's website under personal protective equipment EUAs.

KN-95 masks are those manufactured in China as signified by the “K”. Some of the KN-95 respirators are included on the FDA's approved list and some are excluded. It is important to note that the EUAs for masks from other countries are approved only for use by healthcare providers.

Disposable surgical masks: Surgical masks are certified to be resistant to fluid, large droplets, or sprays that may splash to the face when someone coughs, sneezes, talks, sings, or performs medical procedures. They are looser fitting than a respirator and do not need to be fitted to the individual. They offer some protection from inhaling smaller droplets but are not considered adequate protection if the risk of exposure is high. Surgical masks are made of 3-4 layers of specialized fabric. The outer layer blocks liquid, followed by a layer that uses electrostatic properties to absorb bacterial and viral particles, and 1-2 layers of a physical barrier. Surgical masks are intended to be worn once because it loses effectiveness with repeated use. To wear a surgical mask, unfold the pleats and make sure they are facing down. The nose wire at the top should be comfortably pinched for a snug fit to prevent leaking from the top of the mask. It should cover your nose, mouth, and chin. There should not be a gap on either side of the mask. If the mask becomes wet, it should be thrown away.

Cloth masks: Effective cloth masks or face coverings contain 2-3 layers of fabric with or without an inner filter. The fabric should allow you to breathe comfortably, but it should also be tightly woven. This means you should not see light passing through it when you hold it up to a light source. Cotton or cotton blends are a good choice for cloth face coverings. Make sure the cloth is washable so that it can be cleaned in a washing machine after each use. Wearing cloth masks prevents the wearer from spreading infected droplets when breathing out. It may also offer some protection from breathing in large droplets but is not considered adequate protection in situations where there is a high risk of exposure to those infected with COVID-19.

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Cautions for consumers

Unfortunately, counterfeit N-95 masks are currently being falsely marketed and sold. To protect from buying a false N-95 mask, look for the NIOSH (National Institute for Occupational Safety and Health) approved markings on the mask themselves and the box containing them. More information about recognizing counterfeit N-95 masks can be found on the CDC website.

Masks with a valve or vent: These types of masks have a circular outlet that allows air to escape. The valves allow respiratory droplets to escape defeating the primary goal of using a mask. These types of masks are not recommended to be used during the pandemic.

Plastic face shields or goggles: Plastic face shields and googles are meant to protect the eyes from virus exposure and should always be worn with a recommended face mask. Because of the large gap around the nose and mouth, they do not protect from virus droplets being spread if used alone.

Because wearing a mask or face covering does not fully protect the wearer, you must continue to frequently wash your hands with soap and water for 20 seconds, practice physical distancing of at least 6 feet, and avoid close contact with people who are sick.

The CDC recommends that the following individuals not wear a face covering:

• Children under the age of 2 years old
• Anyone with trouble breathing through the mask/face covering or wearing a mask would put them at a health risk.
• Anyone unable to remove the mask cloth face covering if they develop difficulty breathing

For more information about wearing masks, visit:

• CDC's guide to masks
• FDA's webpage on Personal Protective Equipment