Everything you need to know about wearing masks – until the CDC tells us more


Friday afternoon April 4, the CDC officially started recommending more widespread wear a mask, including by people who have no symptoms of COVID-19. More specifically, the CDC “recommends wear cloth face covers in public places where other social distancing measures are difficult to maintain (for example, grocery stores and pharmacies) mostly in areas of significant community transmission.

CDC guidelines are aimed at reducing transmission COVID-19 from people infected but not yet showing symptoms; there is still not enough evidence to show that wearing a mask reduces the carrier probability of catching COVID-19.

The CDC also says that it is “essential to emphasize that maintaining a social distance of 6 feet remains important to slow the spread of the virus”, but its guidelines masks are incredibly vague. In fact, nowhere on the CDC pages on wearing or make cloth masks does the agency mention the most important aspect of wearing masks: wearers wash their hands before and after putting on the mask and after each time they touch it.

The CDC should provide more advice on the safety and proper use of masks, according to Shanina Knighton, PhD, RN, clinical nurse and infection preventionist at Case Western Reserve University in Cleveland, Ohio. If people don’t get continuing education and focus on past behaviors that reduce infections, she says, they tend to focus only on what’s new.

“When you tell someone to do something, if you don’t give them clear instructions, it will become a safety concern,” said Dr. Knighton. “I can see someone literally bleaching bleach – dip a mask in bleach and let it dry – and put it on their face and think that because it’s an EPA approved product, I am now protected against COVIDs. But now you have skin irritation and you inhale bleach all day. »Shortly after EPA announced that bleaches kill COVID-19, several bleach poisonings have occurred in the country by people drinking bleach in an attempt to kill the virus.

Even the World Health Organization, whose position on masks has continued to evolve, has highlighted the importance of proper use and disposal of masks and has reinforced behaviors with stronger evidence behind them.

“Mask or no mask, there are proven things we can all do to protect ourselves and others – keep your distance, wash your hands, cough or sneeze in your elbow and avoid touching your face”, the WHO tweeted April 6. “Masks alone cannot stop the # COVID19 pandemic. Countries must continue to search, test, isolate and treat each case and find each contact, “WHO said.

People will make mistakes or assumptions if they have not been properly informed about how to wear and care for the masks, including concerns about skin irritation. The CDC page on mask making says nothing more about bleaching than “A washing machine should be enough to properly wash a face covering.” ”

“You can’t make this information public without telling them how to launder it,” said Dr. Knighton. “You tell them to wear it in public. What should I do when I start eating my food? Where should I put my mask? Should I put it under my chin and continue eating? What happens when this person drops it on the surface? What happens if someone sneezes on the outside of your mask? Do you remove it immediately? Do you leave it on your face? It’s just not clear, and it doesn’t share the things people usually come across. ”

The CDC also neglected to mention the option of homemade disposable masks, such as those made with paper towels, which may be more hygienic for those who cannot wash cloth masks frequently or sufficiently or lack resources. reliable and safe for laundry. George Yang, MD, a plastic surgeon in New York, created a Youtube video show people how to make and wear paper masks for one-time use.

Whether people use fabric masks or DIY paper masks, however, they must understand the correct label, including coughing and sneezing.

“Masks for some people mean they can cough and sneeze without covering their mouths, thinking that the droplets will not pass through the mask,” said Dr. Knighton. “It is the social responsibility of the CDC to provide full instructions for the masks, including that people continue to wash their hands and make sure they use an appropriate cough and sneeze label. These masks will help, but we still need you to cough and sneeze into your elbow. “

the WHO has recognized the need for further research into the use of the mask for the general public. To try to fill the gaps that the CDC left open with advice on masks, Dr. Knighton answered common questions about wearing masks as much as possible with the existing evidence.

What is the most important thing to do when wearing masks?

There are actually three things. First, wash or disinfect your hands, clean your face with a warm, damp cloth and allow your face to dry before applying your mask. Second, avoid touching your face. Third, always wash or disinfect your hands before and after applying and removing your mask. When removing your mask, only remove it from the ear straps, such as this video from WHO.

What should I use to make my mask?

Even if the goal of wearing a mask is to prevent droplets from reaching other people, you still need to be able to breathe. Use porous materials that have tiny holes or pores (like a sponge) that allow gas to pass through them, like cotton. Avoid using waterproof materials, such as waterproof nylon and polyester, as they may not provide enough space between fabrics for safe breathing.

The CDC provides three ways to make masks, including a sewn mask, a seamless pattern from a T-shirt and a pattern with a bandana. Other instructions include that one by Johns Hopkins, that one with a video by Kaiser Permanente, and this video using shop towels.

If you prefer not to use a cloth mask, you can use paper towels or coffee filters to make disposable masks, but avoid any plastic or other material that might suffocate. According to Dr. Michael Klompas, a doctor specializing in infectious diseases at Brigham and Women’s Hospital in Boston, a scarf may not work as well as a mask that fits your face.

How can I manage the use of my mobile phone while wearing my mask?

2018 survey shows people are using their phones up to 52 times a day and that the phones are 10 times dirtier than a public toilet– you don’t want to put the phone against your mask. It will take a lot of effort to avoid reaching your cellphone when it rings, so when you are in public, like visiting a grocery store, consider silencing your phone completely to avoid catching it if it rings. You will not be able to talk about it right away if your face is covered by the mask because it will seem muffled.

Pay attention to how you interact with your mask and your phone. Putting a contaminated phone on your mask contaminates the mask. Pulling your mask under your chin potentially contaminates your mask. Gently wipe your phone with 70% isopropyl alcohol or a disinfectant wipe to remove the virus. Be careful not to put your phone on surfaces, then apply it directly to your face.

Do I have to wear a mask everywhere, including at home?

While the CDC recommends wearing a mask in public, for your safety, DO NOT wear the mask while driving if it obstructs your view. The CDC has not made recommendations about wearing masks at home if no one has symptoms of COVID-19. If someone has cold symptoms in your home, they should wear masks in combination with social distancing, hand hygiene, and the cough and sneeze etiquette.

You don’t need to sleep in your mask. Your mask should be removed only by the ear straps, never by the front of the mask. The CDC did not specify whether it is necessary to wear masks during walks or in public parks where there are few people or if you are more than six feet away.

If I have to remove my mask in public, where should I put it until I can put it back on? What if I need to eat or drink something while wearing a mask?

There is limited research in this area, but think of your mask as part of your face: wash your hands before touching the mask and gently remove it only by the ear straps. To store it, have a designated brown paper bag with you where you can put it when you’re not using it so you don’t put it down. If you are in public every day and will wear the mask for hours, change your brown paper bag daily.

When using the bag, label one side “outside” for the outside side of the mask (the side facing the audience), and label the other “inside” for the inside part of the mask (the side near your mouth) . Always put the mask in the bag with the inner part corresponding to the side marked “inside” so as not to contaminate it with what is on the outer part of the mask.

My mask is wet from the condensation of my breathing. Should i change it?

In healthcare, the use of disposable masks helps solve this problem, but if you are using a cloth mask and it happens often, determine if the cloth you have is breathable or too thick. The CDC suggests using a T-shirt, presumably cotton, for DIY masks. However, this History of NBC notes that a study finding that other tissues may work better – this is an example of an area where more research is essential.

Sweat-absorbing or moisture-absorbing fabrics, similar to Dryfit, have not been tested, but they can help absorb moisture from breathing. Avoid waterproof materials. If the liquid cannot pass through them, it can be difficult to breathe through them. A study that looked at the effectiveness of cloth masks notes the humidity inside the masks as a problem and a risk of germ transmission.

How often should I wash my mask? Do I need more than one?

These questions deserve further scientific investigation and direction from the CDC, but until we have these indications, these are my recommendations based on my experience and expertise. Ideally, masks should be changed after each wear, but this may not be possible for most people. Assuming that no one in your house is sick, it depends on how many times you leave your house every day and how often you change it every week.

Try to have two masks when the other is white. How often you change it also depends on how long you wear it and where you go in public. Everyone should be a social distancer, but in places like grocery stores, you may want to engage with closer people.

To avoid potential contamination of the mask, I suggest you wash it when you return, especially if you don’t know the next time you need it. This prevents you from having a potentially contaminated mask in your home.

What detergents should I use to wash my mask?

This issue also merits research and advice from the CDC, but so far we can only rely on limited evidence from studies on irritation of contact dermatitis. Many detergents can cause skin rashes, and most detergents contain scented and enzymatic ingredients that can cause clogging of pores or rashes, so the best option is to use detergents without fragrances or enzymes. If you wash your masks with the rest of your clothes, rinse them longer with clean water to make sure the scents are removed. Treat your mask as if it were your face with the same sensitivity as your skin.

Are there chemicals, such as fabric softener or bleach, that I shouldn’t use to sterilize or wash my mask?

Again, treat your mask as if it had the same sensitivity as your skin as it will be against your skin for long periods of time. It is best to avoid fabric softeners, bleach and any ingredients allergic reaction, rash or other symptoms, including perfumes that can cause headaches after long exposure. Also, do not spray masks with products such as lysols and other disinfectants as their labels indicate that they may irritate the skin.

Should I dry my mask in the dryer or air dry it?

You can dry your mask in the dryer, but avoid using dryer sheets. To air dry it, hang it on a hanger, clothesline or clothes line.

What does mean “well adjusted but comfortably against the side of the face “against my face?

You should not see redness or deep lines on your face as a result of wearing your mask. Some people die more easily than others, but if you see an imprint on your skin, you need to loosen your mask. There should be a full suction cup around the nose and chin with minimal space or an opening on the side. If the mask makes breathing difficult because it pushes against your nose, loosen your mask. Skin degradation and pressure sores may occur if the straps or mask are too tight. In addition, materials such as elastics create tension.

Will the mask catch all the droplets when I cough and sneeze?

No, you should always cough and sneeze in your elbow. Because the tissue must be porous for you to breathe, the droplets can still pass through. The mask helps reduce the amount of droplets that would come out of your mouth or nose if your face were exposed. It can also help reduce the droplets that would spread from others to your face, although the existing evidence to prevent infection in this way is weak unless someone coughs directly into your face.

Who should not wear a mask?

The CDC currently recommend against masks for children under 2 and “anyone who has difficulty breathing, or who is unconscious, unable or otherwise unable to remove the cover without assistance. “

If I have a preexisting condition, like asthma, which is already making breathing difficult, will wearing a mask make it worse?

There is not enough evidence to know the effects of wearing a mask in people with asthma, but asthma is often associated with risk of anxiety and for allergies, one condition sometimes triggering the other. It is possible, but not shown in research, that wearing a mask could affect the relationships between these conditions.

Until we have more data on masks and conditions like asthma, people should follow their best judgment. If your anxiety, asthma, allergies or a similar condition makes breathing too difficult when you are wearing a mask, take it off immediately and speak to a healthcare practitioner.

I need to carry oxygen. Should I put my mask on the oxygen tubes?

This question requires more research and guidance from the CDC. If you choose to wear a mask while receiving oxygen through a nasal cannula, be aware that the SARS-CoV-2 virus can remain infectious on the plastic, so the outside of these tubes must be cleaned each time that someone comes back after leaving their home.

What should i do if i start to develop a rash to wear my mask?

Wash your hands, remove the mask at home by the straps, wipe your face with a clean cloth and let your skin recover. Facial moisture can cause skin rashes. Although not yet studied in ordinary people, personal protective equipment (PPE) was shown cause contact dermatitis in up to 33% of healthcare workers. The risk of developing a rash depends on a number of factors, including how long you wear it, how much moisture is produced, and how sensitive your skin is to certain materials.

Wearing a mask will make me pop more pimples?

We do not yet have enough evidence to answer this question among ordinary people. If your skin is prone to breakouts due to dryness or humidity, assess your face before and after wearing your mask and note the changes in your skin so you can adjust the use of the mask as needed. Remember, the longer you stay at home, the less mask you need to wear.

What should I do if someone sneezes or coughs on the outside of my mask?

Turn away from the person immediately and remove the mask by the straps. If you are in public, throw the mask away immediately to avoid spreading potential germs outside the mask to yourself or others. Throw it away if it’s disposable or you can make another one. If this is a cloth mask that you need to keep, put it in your paper bag. Wash your hands immediately after removal. Remember to continue the social isolation while wearing your mask.

Do I have to shave my beard to wear a mask safely?

This is yet another question that requires further research. the Occupational health and safety administration does not require shaving the beard but specifies that a beard should not interfere with obtaining a complete seal with the mask. If your beard is exposed from the outside of the mask, there is not a good seal for the areas of the nose and chin, which need to be covered.


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