As cases of the novel coronavirus continue to surge, there has been a lot of public discourse about preventative measures. The basics include proper hand washing, avoiding touching your face, social distancing, and disinfecting heavilyused household surfaces.
But there has been a lot of back-and-forth information about the need for and efficacy of facial masks. Salon has compiled an FAQ guide to masks that includes the most recent CDC recommendations, as well as information about supply chain issues for medical professionals.
Should I wear a mask in public?
Yes, you should, but the messaging hasn't always been clear on this. It wasn't long after the first cases of the novel coronavirus were confirmed in the United States that pharmacy workers began reporting that their shelves had been cleared of hand sanitizer, disposable gloves, and face masks. At the time, the Centers for Disease Control and Prevention urged Americans not to wear a mask unless they were sick, caring for a sick person who was unable to wear one or working in health care.
On Feb. 29, the U.S. Surgeon General, Jerome Michael Adams, tweeted, in all caps, that people should "STOP BUYING MASKS!"
"They are NOT effective in preventing general public from catching #Coronavirus," Adams wrote. "[But if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk!"
Seriously people- STOP BUYING MASKS!
They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk!
— U.S. Surgeon General (@Surgeon_General) February 29, 2020
But then came a big turnaround in public guidance.
On April 3, President Donald Trump announced that the CDC was now recommending that everyone in the United States wear "cloth face coverings in public settings where other social distancing measures are difficult to maintain," such as pharmacies or grocery stores.
Trump clarified in the press conference that the guidance was voluntary.
"You can do it, you don't have to do it," he said. "I'm choosing not to do it."
But per the new CDC guidelines, these increased protective measures are a way to slow the spread of the virus and help people who may have the virus and are asymptomatic from transmitting it to others.
Is there still a mask shortage for medical professionals?
Very much so. It's well-known that there is a shortage of personal protective equipment (PPE) for medical professionals and other frontline workers. The New York Times described it as "a war with no ammo," as doctors are being forced to reuse single-use N95 masks — highly-protective respirators common in hospital settings — for weeks at a time, putting themselves at significant risk.
And while institutions across the U.S. continue to find small stashes of PPE in really bizarre places, like in the crypt of the National Cathedral, mask manufacturers are reporting they are at capacity and are months away from being able to manage increased production. Meanwhile, as ProPublica reports, price gouging has begun and, as states are having to outbid each other for supplies, New York state is now buying masks at 15 times the normal price.
Will the invocation of the Defense Production Act mean that there will be more masks soon?
Medical professionals across the United States are calling for a coordinated deployment of the Defense Production Act, the Korean War–era statute that empowers the federal government to increase the manufacturing and distribution of essential medical supplies, including PPE. But Trump maintained for weeks that the invocation of the DPA was something of a last resort, only to be deployed if private industry couldn't rally and pivot in this time of crisis, despite numerous supply chain experts saying that was short-sighted.
"We have used it a number of times, very powerfully," Trump said in a press briefing. "And a lot of times you don't have to exercise the act, you just say, 'Look, if you don't do this, we are going to use the act.' And we have done a great job with it."
In recent weeks, Trump has moved to a scattershot invocation of elements of the DPA, like dictating the production and delivery schedules of private companies.
Last week, he attempted to prevent 3M, the company behind Post-its and Scotch tape — which also currently produces 35 million masks per month in the U.S. — from shipping masks out of the country. 3M responded that this would have grave "humanitarian implications" and that international retaliation would likely result in a net loss of masks available in the American medical professionals.
"Ceasing all export of respirators produced in the United States would likely cause other countries to retaliate and do the same, as some have already done," said a statement from the company. "If that were to occur, the net number of respirators being made available to the United States would actually decrease. That is the opposite of what we and the Administration, on behalf of the American people, both seek."
Then on Monday, Trump struck a deal with 3M. The company will produce an additional 55.5 million N95 masks per month, while also being allowed to continue exporting masks to Canada and Latin America amid the coronavirus pandemic.
Per Politico, what many state leaders are recommending is that Trump use "DPA's broad authority to appoint a single coronavirus czar with a specialized team to coordinate an industrial response to the virus."
That, they say, could avoid continued confusion over medical supplies.
So, how can I get a mask without cutting into supply for medical professionals and frontline workers?
Simple: Just use other, non-medical masks. The N95 shortage is why the new CDC guidelines specify that individuals should wear "cloth face masks," and reserve medical masks for the professionals who need them. These are two different categories of masks, which means that if you make or buy your own cloth mask, you won't be cutting into precious supplies meant for frontline workers.
That said, if you have boxes of unopened N95 masks, consider donating them to local medical workers.
I've seen people wearing bandanas, cut-open bra cups, vacuum liners and feminine products as "masks." Are these effective enough to use as a mask for an ordinary citizen?
- fit snugly but comfortably against the side of the face
- be secured with ties or ear loops
- include multiple layers of fabric
- allow for breathing without restriction
- be able to be laundered and machine dried without damage or change to shape
If your homemade option doesn't adhere to these guidelines, it's not going to be as effective.
What if I want to make my own mask?
Great! The CDC offers both sew and non-sew recommendations on their website, complete with diagrams and instructions. If you are a more visual learner, here's a video that shows how to make the non-sew option:
What if I'm not that crafty?
A lot of local businesses who are out of work have pivoted towards creating face masks (for example, in my city, I know several costume designers and hat makers who have started making and selling masks). Support your local craftspeople — as long as their creations meet the CDC guidelines — if you can. There are also numerous online retailers who have started selling cloth masks.
According to The Verge, Etsy sellers have sold hundreds of thousands of cloth face masks in the past few days, the company says.
"We hope that increasing the availability of fabric, non-medical grade face masks from Etsy sellers will allow more medical and surgical masks to reach the people who need them most: front-line health care workers," Etsy CEO Josh Silverman said in a statement Friday.
Do I need to include a filter in my mask?
Although many see the masks as a tool from getting sick themselves, the masks are mainly to prevent the accidental transmission of the virus to others through speech or breathing, especially if one is asymptomatic. Therefore, a few layers of fabric should be sufficient. Of course, adding a filter will just increase protection for everyone, but the new CDC recommendations don't specify what kind of filter to use, if at all. According to a recent study by Cambridge University, the most important thing to consider when crafting or wearing a mask is to ensure that breathing is not disrupted by the layers of the mask.
"If respiratory protection is not capable of accommodating the breathing demands of the wearer, then the device will impose an extra breathing load on the wearer, which is especially impracticable for people with breathing difficulties," the study says. "Furthermore, the extra breathing load may induce leakage owing to the increased negative pressure in the face mask."
There are a lot of web tutorials that recommend using items like felt, panty liners and coffee filters, but there is limited evidence that these are actually effective, and many of them are uncomfortable to breathe through.
However, researchers from the University of Edinburgh tested several different, common masks and used a particle counter to see how many particles would make it through; they found that dust respirators with filters rated for PM 2.5 were about 97-98% effective.
These filters are available online, but many have a long fulfillment time.
But remember the CDC recommendations for cloth face masks simply specify that they need to be made with multiple layers of fabric. Any mask that adheres to those guidelines is better than no mask in public situations where social distance may be difficult to maintain. Just remember to also keep up with the other CDC recommendations regarding hand washing, face touching, and disinfecting commonly-used household surfaces to keep everybody safe.
Is there a way I can help get PPE into the hands of medical workers who need it?
Yes! Consider donating to groups like Masks for America. Led by a team of American medical professionals, this initiative has found and partnered with an FDA-certified manufacturer selling N95 equivalent masks at only $2 per mask — a fraction of what hospitals and governments have been paying for N95 masks.
Every dollar donated goes directly to mailing masks to health care facilities who request them.