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Is wearing a mask necessary? Does it prevent the spread of COVID-19?

The short answer is: YES!

In addition to hand washing and social distancing, wearing a mask in public is one of the most effective tools we can use to reduce the spread of COVID-19.

Some studies have shown that up to 40% of individuals with COVID-19 can have minimal or no symptoms and can unknowingly transmit the virus to others. Also, because of their minimal symptoms, they may not feel they have the virus and be more inclined to venture out into public. This is the main rationale for all individuals (regardless of symptoms) to wear a mask or face-covering in public.

Face masks prevent transmission from infected individuals, including those who have asymptomatic or pre-symptomatic infection. When you talk, cough, or sneeze, large respiratory droplets containing the COVID-19 virus can be expelled in the air. Face masks trap these larger droplets and prevent the spread of the virus from infected individuals. Face masks also protect the wearer’s nose and mouth from contact with droplets, splashes, and sprays that may contain germs including the COVID-19 virus.

We do have evidence supporting the efficacy of face masks. Several laboratory studies looked at respiratory droplets and the ability of various masks to block them. These studies have shown a significant reduction in the amount of respiratory viruses emitted in droplets and aerosols using a variety of face masks.

We also have real-life epidemiologic data from the COVID pandemic that supports the use of face masks. A recent study published in Health Affairs, for example, compared the COVID-19 growth rate before and after mask mandates in 15 states and the District of Columbia. It found that mask mandates led to a slowdown in daily COVID-19 growth rate, which became more apparent over time. The first five days after a mandate, the daily growth rate slowed by 0.9 percentage points compared to the five days prior to the mandate; at three weeks, the daily growth rate had slowed by 2 percentage points.

Another study looked at coronavirus deaths across 198 countries and found that those with cultural norms or government policies favoring mask-wearing had lower death rates.

Two compelling case reports also suggest that masks can prevent transmission in high-risk scenarios, said Chin-Hong and Rutherford. In one case, a man flew from China to Toronto and subsequently tested positive for COVID-19. He had a dry cough and wore a mask on the flight, and all 25 people closest to him on the flight tested negative for COVID-19. In another case, in late May, two hairstylists in Missouri had close contact with 140 clients while sick with COVID-19. Everyone wore a mask and none of the clients tested positive.

Currently, the U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) recommend the general public wear non-surgical face masks (e.g. cloth or fabric masks) in areas where social distancing is difficult (e.g. in public settings, in congregate living settings, on public transportation). These measures should be followed by all individuals but should be emphasized for older adults and individuals with chronic medical conditions in particular.

You should avoid touching your eyes, nose, and mouth when putting on or removing your mask, practice hand hygiene before and after handling the mask, and launder cloth masks routinely. Ideally, cloth masks should be washed after each use. Wearing a face mask does not diminish the importance of other preventive measures, such as social distancing and hand hygiene.

Why weren’t masks recommended at the start of the pandemic?

At the start of the pandemic, experts did not yet know the extent to which people with COVID-19 could spread the virus before symptoms appeared, nor was it known that some people have COVID-19 but don’t have any symptoms. Both groups can unknowingly spread the virus to others.

These discoveries led the CDC to change its recommendation to support and recommend the use of face masks. The CDC updated its guidance to recommend widespread use of simple cloth face coverings to help prevent transmission of the virus by people who have COVID-19 but don’t know it.

Early on, there was also some concern over the development of critical shortages of surgical and N95 face masks with a public face mask recommendation which delayed the recommendation for the general public to wear face masks. The CDC acknowledged this concern when it recommended cloth masks for the public and not the surgical and N95 masks needed by health care providers.

Surgical vs cloth mask? Does it matter?

Both cloth and surgical face masks protect the wearer’s nose and mouth from contact with droplets, splashes, and sprays that may contain germs including the COVID-19 virus as well as filter out large particles in the air. While surgical masks may offer more protection, studies have shown that properly made cloth face masks can approach the filtration efficacy of medical masks.

While surgical and N95 masks are in short supply and must be reserved for health care providers, cloth masks are easy to find or make and can be washed and reused. These qualities make cloth face masks a great tool for the general public to help reduce the spread of COVID-19. Cloth masks can be made from common materials, such as sheets of tightly woven cotton (e.g. bandannas, t-shirts). Cloth masks should include multiple layers of fabric. Instructions are easy to find online and the CDC website even includes directions on how to make no-sew masks. Click here for instructions on how to make your own masks. 

Is it safe to travel?

The bottom line is that staying at home and avoiding highly populated areas is one of the best ways to protect yourself and others from getting sick.

COVID-19 cases and deaths have been reported in all 50 states and case rates and travel restrictions are constantly changing. Unfortunately, since the lift of travel restrictions and opening of public facilities, we have seen an increase in COVID-19 cases, especially in popular travel destinations such as Florida. There is definitely an increased risk of catching the virus with travel to highly populated areas such as beaches and other areas with high concentrations of people. Individuals with chronic health conditions who may be at increased risk if they contract COVID-19 should avoid traveling to these areas. Also, family members who travel should consider quarantining from other family members with chronic health conditions after traveling to high-risk areas.

Clearly, do not travel if you have symptoms of COVID or have had a positive COVID test without talking to your primary care provider. If you do travel, make sure to frequently wash your hands especially after you have been in a public place, after touching surfaces frequently touched by others, after blowing your nose, coughing, or sneezing, and before touching your face or eating. Avoid touching your eyes, nose, or mouth, maintain social distancing, and pick up food at drive-throughs, curbside restaurants, or stores.

Anticipate travel needs and be sure to bring enough medication to last your entire trip. Pack alcohol-based sanitizer (at least 60% alcohol) and keep it within easy reach. Make sure to bring a face mask to wear in public areas.

Follow state and local travel restrictions. For up-to-date information and travel guidance, check the state or local health department where you are, along your route, and at your planned destination. While you are traveling, it is possible a state or local government may put into place travel restrictions, such as stay-at-home or shelter-in-place orders, mandated quarantines upon arrival, or even state border closures. Plan to keep checking for updates as you travel.

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