There’s compelling new evidence that if 80% of people wore a mask, cases of COVID-19 would drop dramatically, and universal mask-wearing could be a huge tool in our global fight against the pandemic. But what exactly do masks do, and why does mask protocol seem so confusing?
For that, we need to back up to March, says Jeff Pothof, MD, Chief Quality and Safety Officer at UW Health in Madison, Wisconsin. In the earliest days of the COVID-19 pandemic, health experts did not want people to wear masks. “PPE was in short supply,” says Pothof. “I don’t think anyone wanted there to be a run on masks when we thought there wasn’t much benefit.” On top of that, says Pothof, there was real reason to believe that people who wore masks actually touch their faces more frequently.
As the weeks wore on, and researchers learned more about COVID-19, it became apparent that masks could be highly useful to prevent spread. “We knew there was asymptomatic transmission, but we didn’t think it was a super-likely way for people to get infected,” says Pothof. “We thought people who were symptomatic would be shedding much more virus than people who were asymptomatic.” As it turned out, studies showed there’s actually a pretty large population of people with COVID-19 who have no symptoms at all and can transmit the virus. “So, that got us worried,” he said.
Finally, additional research showed that you don’t need to cough and sneeze to transmit COVID-19. “Those events generate a lot of droplets, but they’re not super-common,” he explains of how experts originally thought the virus spread. “Even sick people aren’t constantly coughing and sneezing. But they had a study that said even talking could generate droplets with enough force to infect people.”
This is when the guidance on mask-wearing changed, and experts now suggest we all wear masks in public spaces. “We still had the risk of healthy people potentially infecting themselves, but we had what was thought to be was a large cohort of people who would have COVID-19 with no symptoms at all who, even just talking in close proximity to other people, could infect others,” says Pothof.
Here’s what you need to know about wearing your face mask or covering:
Will a mask prevent me from getting sick? While there is probably minimal benefit, and a healthy person wearing a mask is better than not wearing a mask at all, it’s not an effective tool to prevent infection. “These loop masks are not so tight-fitting and fit-tested,” says Pothof. “If you blow hard, you can feel the air come around the side of those masks. The same thing, if you breathe in, there’s air coming around the side of the masks that can contaminate you.”
Their primary benefit is to prevent asymptomatic people from transmitting the virus to others. With the fabric or cloth so close to your face, you are emitting fewer droplets into the air. “If you wear one of those masks and start breathing, you start to sense moisture in the mask,” says Pothof. “That is your mask catching those droplets. If you were infected with COVID-19, that is where the virus is. And the virus has a much harder time getting out of that mask when it is on your face.”
What kind of mask should I wear? Masks that doctors wear as personal protective equipment (PPE), like N95 masks, should still be reserved for healthcare workers. Beyond that, you have options. Materials like silk, or other fabrics with large pores where air can easily pass through, will likely be less effective protection.
“I think most people are probably comfortable with the idea that any kind of double-layered mask that’s available whether it’s sewn or made out of a paper product, is probably providing enough protection, even if it’s not perfect protection, in the environments where they are wearing them—trying to stay socially distant, not in someone’s face,” says Pothof.
At this moment, there is no universal standard for what type of fabric to use. “With time, if this becomes something we think about with every respiratory season, I bet there will be people who do testing on all these different fabrics and try to tell us which perform better than others,” says Pothof. “But a lot of that information is not out there yet.” That said, something is definitely better than nothing, so wear any face covering you can—even if it’s a repurposed bandana.
When should I wear my mask? Pothof says there seems to be a lot of confusion about when exactly masks should be worn. “When I’m out in the community, I see all kinds of things. I see people alone in their cars wearing a mask,” he says. Remember, your mask is mostly there to protect others. So if you are near others, you should be wearing your mask. “You want to wear a mask when you are out in public and there’s a chance or high likelihood that you are going to get six feet or closer to another individual for a prolonged time,” Pothof says. “Grocery stores are great examples. There’s a reasonable chance you’ll be closer than six feet to another person. A lot of businesses are like that.”
“Am I going to leave my house and be near others or have the potential to be near to others? That’s when we should wear a mask.”
Remember, by wearing a mask, you are helping others. Pothof says he’s seeing some people have the attitude that they’re tough, and don’t need a mask—which is the wrong attitude to have. He likens it to the use of seatbelts in the 1980s, where people initially weren’t super-receptive to the idea that these devices were great, protective equipment that could make our population safer. “I think we need to quickly normalize this idea that we wear masks, not because we are weak or there’s something wrong with us, but because we care about other people and we don’t want to make other people sick,” says Pothof. “It’s just something that we need to do to show that we’re all in this together and we’re going to beat it.”
This information is for educational purposes only and is not intended as a substitute for medical diagnosis or treatment. You should not use this information to diagnose or treat a health problem or condition. Always check with your doctor before changing your diet, altering your sleep habits, taking supplements, or starting a new fitness routine.