All your questions about how to wear a face mask -- answered

Face masks can be unexpectedly complicated, especially for those who are new to wearing them.Navigating which ones you should buy and understanding wh...

Posted: Apr 25, 2020 7:49 AM
Updated: Apr 25, 2020 7:51 AM

Face masks can be unexpectedly complicated, especially for those who are new to wearing them.

Navigating which ones you should buy and understanding who they protect, figuring out if you can reuse them and how to get your little ones to wear them are daunting tasks.

Social distancing is still our best bet to prevent further spread of the coronavirus. But since April 3, Americans have been encouraged by the US Centers for Disease Control and Prevention to wear "cloth coverings" in places where distancing guidelines are hard to maintain.

But is your bandana really helping you? Should only people who know they're infected wear masks? And what if your kids throw a tantrum when you ask them to put one on?

We answer every question readers have been asking about face masks.

Should I wear a mask in public?

On April 3, the CDC shifted its guidelines to recommend that we should wear "cloth coverings" in public places where other social distancing measures are difficult to maintain, such as grocery stores and pharmacies.

The updated guidance was in light of new evidence of the high percentage of people spreading the virus asymptomatically. This means the virus can easily spread between people interacting in close proximity by coughing, sneezing or even talking -- even if those people aren't exhibiting symptoms.

Some states require citizens to wear masks in public spaces -- such as Connecticut, Hawaii, Maryland, New Jersey, New York, Pennsylvania and Rhode Island, as of April 20. Some countries, including Germany, Turkey and Jamaica, have required to some degree that people wear masks.

Who is protected by wearing a mask?

The benefit of wearing masks in public isn't to protect you from getting sick. It's to protect others from exposure if you are sick or if you're an asymptomatic carrier. But if we all wear masks, we could help each other, said Dr. Joseph Vinetz, a professor in the infectious disease section at Yale School of Medicine.

"The idea about the face mask is to prevent the virus from coming out of somebody's mouth and nose, mostly out of their mouth," Vinetz said. "They prevent somebody, when they talk or sometimes when they sneeze or cough, from expelling virus and leading to infection in other people."

Wearing a mask doesn't totally prevent you from getting infected, Vinetz added. The virus can live on surfaces for hours, and in trace amounts up to three days, and it's easy to touch your face when you're not wearing a mask.

Even if you wear a mask, maintaining 6-feet social distancing is still important to slowing the spread of the virus. The CDC considers face masks an additional, voluntary public health measure -- but remember to refer to your home state's guidance as well.

What kind of mask should I buy?

Though the CDC recommends we wear masks, we shouldn't buy surgical masks or N95 respirator masks. Those types are desperately needed by health care workers and first responders who are in constant proximity with coronavirus patients every day, and supplies in some areas are dwindling.

You can, however, easily make your own cloth mask from old clothes or other common materials and household items. And you don't even have to sew. You can make one using a bandana and coffee filter. US Surgeon General Jerome Adams showed us how to make face masks with a T-shirt and rubber bands in this CDC video.

"Ultimately, it's about having some form of barrier with multiple layers," said CNN Chief Medical Correspondent Dr. Sanjay Gupta in a CNN video on why masks in addition to physical distancing are important.

Masks made with a combination of cotton with natural silk or chiffon may also effectively filter out aerosol particles, according to a new study published Friday in the American Chemical Society Nano journal. Our respiratory droplets form in a range of sizes, but the tiny ones, called aerosol particles, can slip through the gaps between certain cloth fibers.

You could substitute the chiffon with natural silk or flannel, or use a cotton quilt with cotton-polyester insulation, to achieve similar results, the study said.

There are also disposable cloth masks you can buy in a store or online. They're not made for surgery or hospitals, but they are effective for your needs and widely used.

What's the difference between a surgical mask and an N95 mask?

"When we talk about face coverings, there are the surgical masks I wear in the hospital to protect patients from my own germs and avoid any splashes," said Gupta, who works as a neurosurgeon.

N95 respirators are masks that must be fitted to the faces of health care workers to protect them during certain procedures, Gupta added.

"It's the only one of these masks that prevents most very small particles from getting in, when used properly," he continued. "We need to keep those masks in their hands."

Are cloth masks as effective as medical masks?

Medical-grade masks are more effective, but that "doesn't mean we should dismiss the benefit of cloth masks," Gupta said.

Because of how far our respiratory droplets travel when we talk, cough or sneeze, face masks can still help to contain the range of those droplets.

The researchers in the Nano study used sodium chloride to replicate respiratory particles ranging in size, and blew with a fan the particles across material samples at a rate similar to a person's resting breath. They measured the number and size of particles in the air before and after they passed through the fabric.

One layer of a tightly woven cotton sheet combined with two layers of polyester-spandex chiffon filtered out the most air particles, between 80% to 99%. According to the study, its effectiveness was close to an N95 mask.

Tightly woven fabrics such as cotton can be a mechanical barrier to particles, while fabrics with a static charge, such as natural silk or chiffon, act as a electrostatic barrier, the study said.

However, a very small gap reduced the efficacy of the mask by at least 50%, emphasizing the importance of a properly fitted mask, the study said.

Can you reuse them?

Homemade masks can be reused because they're washable, Vinetz said.

You should launder the masks before and after each use to clean off any germs you may have picked up in public. Hand-wash the masks or put them in a mesh wash bag in the washing machine so they don't come apart, and use a high-heat setting.

If you already have a disposable surgical or medical-grade mask, those can be reused, too. To disinfect it, leave it in a clean, safe place in your house for a couple days, Vinetz suggested. After that, it should no longer be infectious.

Can you microwave them to kill germs?

If you're thinking you might be able to nuke your mask to kill germs, that's "not a great idea," Vinetz said.

"We have no evidence about that," he said. "If there's a metal piece in an N95 or surgical mask and even staples, you can't microwave them. It'll blow up. If you have a homemade or cloth mask or what's called a face covering, you just wash it. Microwaving it is not going to work."

How can I stop my glasses from fogging up?

For those who wear glasses, wearing a mask means figuring out how to avoid our humid breath blocking us from seeing across the grocery store. Or from seeing anything, really.

"To avoid fogging up your glasses -- I have the problem myself -- short of getting Lasik surgery, you have to fold the mask around your nose so that the air coming out of your mouth or nose doesn't rise to your glasses," Vinetz said. (He's not recommending anyone get elective surgery right now.)

How do I get my kids to wear one?

If your child refuses to wear a mask, takes it off and throws it down, chews on it or otherwise, his actions could defeat the point of wearing a mask and raise the risk of infection, said Christopher Willard, a psychiatry lecturer at Harvard Medical School and author of "The Breathing Book," a breathing practice book for kids.

Kids may be apprehensive about wearing a face mask because they're more sensitive to new things than adults are, Willard said.

"There's also the weird psychological aspect of not being able to see their own face or other people's faces and facial expressions," he added, "which really interferes with communication and signals that they [feel are safe]."

To ease their mask fears, buy or make coverings with appealing fabrics, or draw something cool with markers to make them look more fun. Try drawings of your child's favorite superheroes or ninjas wearing masks as they go about helping other people. Show your child your own mask and how, by wearing one, he'll be just like Mom or Dad. See if you can find pictures of your kid's favorite celebrities wearing masks.

Doing so could make your kids feel like the masks are "theirs" and give them a sense of ownership, making them more excited and more likely to wear them, Willard said.

"I think also knowing that they are protecting others can help, and making it fun by talking about it as dressing up like superheroes or something."

And altruism isn't only for kids, but for everyone wearing a mask for the public good.

"It's part of our social contract to look after one another," Vinetz said. "It's social solidarity for everybody in a public place, when told to by public health and political authorities, [to] wear a face covering according to what's recommended."

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