Masking During COVID-19: The True Facts

There have been many mixed messages about COVID and it can be difficult for patients to separate fact from fiction. Here are the latest facts to know.

Masks help prevent the spread of COVID

The confusion patients have about wearing masks is justified, given the mixed messages from government and mass media. At the beginning of the pandemic, face masks were not recommended for the general public for two reasons: 1) the extent to which people with COVID could transmit the virus before symptoms appeared and 2) any available healthcare-grade masks were needed desperately at the time by hospitals and providers.

Recently, both the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) published recommendations for masks due to the growing body of evidence indicating that they can be an effective means of ‘source control’ by preventing droplets of the virus from traveling to others.

Data supports the fact that wearing masks saves lives. According to the latest models from the Institute for Health Metrics and Evaluation, the projected death rate by December 1, 2020, could be reduced by approximately 67,000 if masks were worn universally. Additionally, it estimates that masks could help over 147,000 people avoid infection. On the flip side, the model predicts that there could be an additional 111,000 deaths from projections if mask mandates are eased.

At-risk groups have the most to gain from wearing masks

According to the CDC, frontline, essential and critical infrastructure workers are the most likely to be exposed and contract the virus. Race and ethnicity appear to play roles in who comes down with the virus – likely due to underlying conditions. American Indians and Alaskan Natives are the most likely to contract the virus and require hospitalization, while Black or African Americans are the second most likely to require hospitalization and the most likely to die, according to the CDC report.

Age and sex appear to play roles in COVID mortality rates. Women fare better than men, and the likelihood of dying increases with age. Those 85 years and over have the highest death rates, followed by 75 – 84 years, 65-74 years, and so on. Children have the least risk of death from COVID-19.

Mask types make a difference

The U.S. Food and Drug Administration has not approved a mask to protect against coronavirus. However, a recent study compared 14 types of face masks and ranked them from the most to least effective.

The most effective masks:

  • Fitted N95 (no valve)
  • Surgical
  • Poly/Cotton
  • Cotton

The least effective masks:

  • Knitted
  • Bandana
  • Fleece

It is interesting to note that the study found that wearing no mask was more effective than wearing a fleece mask. The droplet transmission for an N95 mask was below .1%, while the fleece mask droplet rate was 110%. The study concluded that rather than catching large droplets, the fleece mask broke them down into smaller droplets that were expelled from the mask. Bandanas also broke large droplets down in a similar way as fleece but were determined to be better than no covering at all. The N95 mask with a valve protected the wearer from inhaling droplets, but did not protect those around him from being exposed to the virus. The study recommends people using a mask with a valve to also use an additional mask over the valved mask (such as a surgical mask) to provide maximum protection. 

Who should not wear a mask?

The CDC recommends that children younger than two years old, anyone with trouble breathing, and anyone who cannot remove the mask without assistance should not wear one. Wearing masks for activities that could cause the mask to become wet (such as swimming) is not recommended. If wearing a mask during rigorous exercise would impede breathing, the CDC recommends maintaining social distancing and exercising outside away from others.

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