Information about the novel coronavirus (the virus that causes COVID-19) is constantly evolving. We will refresh our novel coronavirus content weekly based on newly published peer-reviewed findings to which we have access. For the most reliable and up-to-date information, please visit the CDC website or the WHO’s advice for the public.
We’re in the midst of the coronavirus disease 2019 (COVID-19) pandemic, and the news right now can be confusing. How can you protect yourself against the virus? Are masks effective?Should you wear a mask in public?
In the early days of the pandemic, there was a rush to buy masks, and many stores ran out of their supply. But on February 28, 2020, the Surgeon General (on Twitter) urged Americans to stop buying masks. He stated that masks “are NOT effective” at preventing the general public from catching the novel coronavirus. He also underscored that continuing to buy masks could prevent healthcare professionals from getting the masks they need to care for sick patients safely (Surgeon_General, 2020a). Mirroring the Surgeon General, the Centers for Disease Control and Prevention (CDC) stated that it did not recommend the use of face masks by people who are well (Center for Devices and Radiological Health, n.d.).
At the same time, images began flooding social media from hospital workers experiencing mask and respirator shortages. These posts illustrated how many healthcare workers have resorted to using the same mask day after day, and that some have begun using more creative “masks,” such as homemade cloth masks. This seemed to drive home the point that the general public should not be using up the country’s limited mask supply.
But then, on April 1, 2020, the Surgeon General stated that he had asked the CDC to review their recommendations regarding mask use, indicating a possible reversal (Surgeon_General, 2020b). In response, the CDC recommended everybody wear face cloth coverings in public settings. These changes have left even more people wondering what they are supposed to do. Are masks recommended, or are they not?
Here is what the CDC is currently recommending regarding personal protective equipment. In addition, it can be helpful to learn how the virus spreads, what the different kinds of masks are, and how else you can protect yourself from the COVID-19 virus.
How does the novel coronavirus spread?
The virus that causes COVID-19 is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although it is believed that SARS-CoV-2 initially came from an animal source, it is now effectively spreading from person-to-person.
“The virus is spread via respiratory droplets from coughing or sneezing,” explains Dr. Patrick Kenney, DO, FACOI. Kenney is double-board certified in Internal Medicine and Infectious Disease and is a faculty member at Cleveland Clinic Florida in Weston, FL.
Respiratory droplets are small particles of saliva or mucus that are expelled from the body when a person sneezes, coughs, or breathes hard. These droplets can travel through the air, eventually falling to the ground (or on other nearby surfaces). And if a person is infected with SARS-CoV-2, the virus can be present inside the droplets.
For a healthy person to be infected with SARS-CoV-2, the virus has to come into contact with his or her mucous membranes, such as the inside of the mouth, nose, or eyes. There are a couple of different ways this can happen:
If a healthy person is in close proximity to a sick person, they can get sick through the air. Respiratory droplets can travel directly from an infected person and land on a healthy person. This is why there is a push to practice social distancing and to maintain a distance of at least six feet from other people. If you don’t come into contact with others, it is less likely you will become infected. (There is also some evidence that the virus can linger in the air for a period of time before falling to the ground, although it is unknown if this occurs in quantities sufficient to infect others.)
Alternatively, a healthy person can touch an object that has the virus on it and then touch his or her face. It’s unclear exactly how long SARS-CoV-2 can live outside of the body, but one study estimates it can survive up to four hours on copper, up to 24 hours on cardboard, and up to 2–3 days on plastic and stainless steel (Doremalen, 2020). This means, for example, that if an infected person coughs on a doorknob, you touch the doorknob within 2–3 days, and then you touch your face—you may become infected. This is why washing your hands frequently is emphasized.
According to Dr. Kenney, face masks may protect against both of these methods of transmission. “Masks do help provide a shield from respiratory droplets,” he says, later adding that they “also may help a person not touch their face.”
But not all masks are created equal.
The different types of masks
Surgical masks (face masks)
These flat masks, with bands that hook around your ears or ties that go behind the head, likely do not provide adequate protection from the coronavirus because they do not create a seal. The sides are open, leaving space for pathogens to enter. These masks mostly provide protection for other people from you, since they’re directly blocking respiratory droplets that may come from your mouth or nose.
Respirators are different from face masks because they form a seal around the face and can protect against airborne particles. Respirators are named with an alphanumeric coding system, so you’ll see one letter with numbers following it. The letter stands for how resistant it is to oil while the number stands for what percentage of airborne particles it can filter out in worst-case scenario testing. There are three letters and three numbers you may see on respirators:
- N = this indicates a respirator is not oil resistant
- R = this indicates a respirator is oil resistant
- P = this indicates a respirator is oil-proof
- 95 = this indicates a respirator filters out 95% of particles
- 99 = this indicates a respirator filters out 99% of particles
- 100 = this indicates a respirator filters out 99.97% of particles
One of the most commonly available respirators, which is also sufficient at protecting against SARS-CoV-2, is the N95 respirator.
Importantly, respirators must be properly fit to the face to be maximally effective. There are several different sizes available, and things like facial hair may compromise the seal. It’s also important to remember that these masks, regardless of type, are not meant for repeated use, because the outside of them may become contaminated. Another thing to check is to make sure the mask is approved by the National Institute for Occupational Safety and Health (NIOSH).
How to safely put on and take off a mask
Before putting on a new respirator, be sure to wash your hands and avoid touching your face. Doing this will give you the best chance of avoiding exposure and contamination. Before you go outside, check to make sure your respirator has created a tight seal on your face. One way to do this is to breathe in and see if the respirator buckles inward (this would be a good sign, but not all respirators do this) and breathe out and see if you can feel air leaking anywhere (this would be a bad sign).
Regardless of type, it’s essential that you remove the mask properly to avoid exposure to particles that may be on the outside of it. When you are ready to take off your mask, be sure to grab the straps that secure it to your head and release them without touching the front of the mask. You should have the mask fall directly into the waste bin or carry it by the straps to one. Once you’ve disposed of the mask (and before touching your face), wash your hands following proper hand hygiene.
Other measures to take to protect yourself from coronavirus
“First and foremost, wash your hands with soap and warm water regularly, as this is the best way to stop the spread of many pathogens, including coronavirus,” Dr. Kenney advises, adding that you should “avoid touching your eyes, mouth, or nose with unwashed hands.” In order to ensure you’re practicing proper hand hygiene, make sure that you’re washing your hands with warm water and soap for at least 20 seconds after using the restroom, after coughing or sneezing, and before eating.
You should also minimize contact with sick people, if possible. “Technology is a great way to facilitate care without exposure,” suggests Dr. Kenney, indicating that you can use technology to both care for others remotely and get in touch with a healthcare provider if you think you are sick yourself.
Finally, everyone should stay up-to-date on information about coronavirus, since recommendations regarding mask use may change.