Everything You Need to Know About Wearing a Mask

President Trump announced Friday—somewhat reluctantly—that the U.S. Centers for Disease Control and Prevention are now recommending that Americans voluntarily wear cloth face coverings in public. The suggestion comes after weeks of federal guidance that ordinary citizens should not wear masks, and its lukewarm tone doesn’t do much to answer the question on many minds: Do I need to wear a mask?

As U.S. Surgeon General Jerome Adams said at Friday’s briefing: “It has been confusing to the American people.”

To clear up some of that confusion, it’s important to note that not all masks are created equal. They generally fall into three categories:

• Respirators: These are the convex N95 masks, approved by the National Institute for Occupational Safety and Health, that filter out 95 percent of large and small particles in the air. They are often constructed from layers of polypropylene, made to fit snugly, and have an expiration date.
• Surgical masks: These are loose-fitting, pleated, disposable masks, often in blue or white, that you might recognize from TV medical dramas. Approved by the FDA, they are splash-resistant and act as a two-way barrier to large particles.
• Cloth masks: These are unregulated masks that can even be homemade and serve simply as an extra barrier with no guarantees.

From the start of the coronavirus crisis, until Friday’s briefing, the federal government had been saying that the average person did not need to wear a mask. There were two main reasons for this:

• Supply issues: Because people began hoarding masks even before COVID-19 arrived in the U.S., there was a massive shortage and medical facilities were having trouble restocking. Authorities wanted to preserve N95 masks for health-care workers who were most likely to be in contact with infected patients, and surgical masks for others in the hospital setting, including sick patients.
• Transmission risk: In the very early days of the pandemic, there was a widespread belief that there was little risk of someone without symptoms transmitting the new coronavirus. Therefore, health officials didn’t think someone who didn’t feel ill needed to wear a mask. But a growing body of research has shown that asymptomatic people are indeed contagious, sparking the push for more widespread mask usage.

Even though the understanding of how COVID-19 is spread has evolved, the CDC does not want you to go out and get a surgical mask or N95 mask if you are healthy; those still must be reserved for medical personnel. Instead, the agency is advising use of what it calls “simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.” So it’s clear the CDC is not saying a cloth mask will protect you from getting coronavirus from someone sneezing near you in the grocery store; they are saying that a mask could stop the spread of the infection from someone who is unknowingly carrying the virus. 

Experts outside the government are divided on the wisdom of this:

• Con: Dr. Jeffrey Klausner, an adjunct professor of epidemiology at the University of California Los Angeles who previously worked for the CDC, said there is “no new evidence” of the benefit. “The response to the epidemic is driven by panic and politics,” he said. “The same way we saw recent FDA approval for some medications that have not had demonstrated scientific benefits. There’s been active discussion and pushback from public health experts and politics. Politicians are saying ‘what’s the harm,’ but public health experts are saying ‘what’s the benefit.’ None, based on scientific evidence.”
• Pro: But Dr. David Larsen, an associate professor in the Department of Public Health at Syracuse University, said we might as well try it. “We are rightfully closing our schools, shuttering our businesses, and disrupting our social lives,” said Larsen. “We need to bring anything that can work to the fight, and face masks may help.”

The next question on your mind is probably: Can a simple piece of cloth do the job? And the answer is: It might be better than nothing. Just as we tell people to cough into their elbows or cover their mouth when they sneeze, a cloth covering can stop some virus-filled droplets from being spewed into the air and onto uninfected people. How much depends on the material: One study found a single-layer handkerchief had a filter efficiency rate of just 2 percent, and a small 2013 test of homemade masks found that a surgical mask was at least three times more effective. The researchers wrote: “A homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection.”

Is there any downside to wearing a mask? Well, Trump thinks it would make him look silly while meeting with “dictators”—but assuming you don’t have any such engagements on your calendar, there are a couple of other things to consider:

• False sense of security: Dr. Deborah Birx, who is coordinating the White House’s coronavirus effort, said there was a concern that people wearing a mask might think they don’t need to social distance. “We don’t want people to feel like, ‘Oh I’m wearing a mask, I’m protected and I’m protecting others.'” Experts agree that social distancing is still key to flattening the curve and pales in comparison to masking.
• Touching your face: Health officials have tried to drive home the warning that as long as coronavirus is around, you must avoid touching your face. That’s hard to do if you are constantly adjusting or taking off and putting on a cloth mask. Make sure you wash your hands before and after you handle the mask to minimize risk of getting or transmitting COVID-19.

If you decide to take the CDC up on its recommendation, do everyone a favor and don’t go to a dozen stores looking to buy a box of masks. Remember: medical workers and first responders really need those N95s and surgical masks. 

As the CDC notes, you can sew a simple mask; the internet is full of how-tos. You can buy them on eBay, you can fashion one out of an old bra, or you can do what this brave lady did. Or you can do what the experts agree will help end the pandemic: stay the hell at home.