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An advanced practice nurse answers common questions about wearing cloth face coverings to prevent the spread of COVID-19
As leaders at the local, state and national levels implement the mandatory use of face coverings in public areas as a direct response to increased cases of COVID-19, understanding the what, how and why behind the use of a cloth face mask can help each of us reduce the spread of the novel coronavirus.
Although you may question why you should wear a cloth face covering even when you’re not sick, remember that many COVID-19 patients didn’t realize they were ill and inadvertently exposed others to the virus.
“One of the problematic realities of COVID-19 is the fact that those who are asymptomatic—meaning, carriers of the virus not showing any signs or symptoms of sickness—are contagious, unknowingly spreading the virus,” said Matthew Sorenson, PhD, APRN, ANP-C, FAAN, assistant dean for graduate nursing education and professor at Texas A&M University College of Nursing. “When someone that is sick with COVID-19 wears a cloth face covering properly, they significantly reduce the odds of transmitting the disease to those around them.”
With a multitude of options available for sale and trending opinions shared online, we spoke with Sorenson to get the facts about face masks with evidence-based answers to commonly asked questions on the subject.
What kind of face covering should I use?
Face coverings can be sewn cloth masks or made from items you already have in your home. The Centers for Disease Control and Prevention (CDC) offers templates and step-by-step instructions for making your own face covering, even if you don’t know how to sew.
“It is important to stress that surgical masks, N95s or any other face covering specifically manufactured for first responders, nurses, doctors and any health care provider, are not necessary for everyone,” said Sorenson. “This personal protection equipment (PPE) is appropriate for and needed by health care providers as they care for and treat patients. A cloth face mask serves as a preventative measure that helps those already ill (even if they are not showing any symptoms) protect those they may come into contact with as they maintain their daily routine.”
Visits to public places with high pedestrian traffic like the grocery store, pharmacy and other places of business where there is an increased risk of exposure are areas where face cloth coverings should be worn to help prevent spread of the virus.
How do I choose a face mask that fits?
In order to provide the greatest amount of protection and most significantly reduce the risk of spreading COVID-19, a cloth face mask must fit properly. The purpose of a mask is to keep droplets from a sneeze, a cough or even a simple conversation from escaping and infecting a passerby.
“There are three main points to consider when ensuring your cloth face covering fits appropriately in addition to ensuring that you are able to breathe easily,” said Sorenson. “It should completely cover your nose, fit securely under your chin and lay flat against the sides of your face.”
How do I know I’m wearing my face mask correctly?
For a cloth face covering to provide protection for those around you, the CDC reiterates your nose and mouth should be covered at all times. “It is not effective to wear any type of face mask or covering if it is not worn correctly,” said Sorenson. “Being diligent in making sure your nose and mouth are covered is essential to its effectiveness. Take a glance in the mirror before you get out of your car or leave your home to double check there are no gaps or openings between your skin and the material of the cloth face covering.”
How do I clean a cloth face covering?
In addition to ensuring a proper fit and use, it is equally important to ensure your cloth face covering is appropriately washed between uses. “The CDC recommends cloth masks be washed after each use on the warmest water setting appropriate for the type of cloth used to make the covering, and the same is true for drying, using the warmest heat setting appropriate,” said Sorenson. “If you opt to hand wash your mask instead, soaking the covering in a diluted bleach water solution is recommended, followed by air drying, preferably in direct sunlight.”
How should I store my mask when I’m not wearing it?
Much like wearing and washing a face mask properly, taking appropriate steps in removing your cloth face mask without touching your eyes, nose or mouth and storing it between uses is important. “When you remove your mask after being in a public space, you should use the ear pieces to pull it away from your face before taking the outside corners and folding them in toward one another,” said Sorenson. “This helps keep any droplets that might have fallen on the outside surface of your mask to be self-contained. Ideally, you would then place this directly in the washing machine and immediately wash your hands without touching your face.”
If you find the need to remove your mask in between visits to public places, Sorenson points out that you should place the mask with the outside facing down in a place where you can easily pick it back up using only the ear pieces. Wash your hands with soap and water or use hand sanitizer after removing it.
“When you are in your car or in your personal work space where physical distancing is easily maintained, be sure to pay attention to how you lay your mask down and how you clean your hands before you touch the rest of your vehicle or your office. Taking precautions to maintain proper hand hygiene while avoiding touching your face remain key in helping reduce the odds of contracting the virus,” said Sorenson.
Should I wear a face mask outside?
Recommendations by the CDC encourage the use of a cloth face covering in public areas—indoors or outdoors—even when physical distancing measures can be maintained, but especially when they cannot. “Cloth face masks serve as a primary boundary between those that are sick and those that are not,” said Sorenson. “By wearing them whenever there is a feasible opportunity to be within 6 feet of a neighbor or a passerby, we are directly supporting the health of our fellow community members and visitors.”
Should I wear a face mask while I’m exercising near others?
“The very short answer is yes. If you are exercising in close proximity to another person, especially in an enclosed or indoor setting, it is highly encouraged that you wear a cloth face covering,” said Sorenson. “It is also important to note that different businesses may have their own policy requiring the use of a face covering so it is important to educate yourself on the guidelines in place of that particular establishment.”
Following face mask guidelines may cause the need to alter your exercise routine and modify aerobic exercises. “If you are a runner, a walker or prefer high intensity aerobic exercise, consider finding areas outdoors like trails or community sidewalks where you can maintain more than 6 feet between yourself and other patrons.”
How do I keep my glasses from fogging when I’m wearing a face covering?
The best way to prevent glasses from fogging while wearing a cloth face covering is to have a nose piece that is flexible and can contour across the bridge of your nose. “Many cloth face masks sold have an option to include this nose piece. If you are making your own, a pipe cleaner can be sewn along the top of the covering,” said Sorenson. As a temporary reprieve, try sliding your glasses down to allow the air to vent, which will reduce fogging of the lenses. Using anti-fog spray may provide a long-term solution.
Am I breathing in too much carbon dioxide wearing a cloth face mask?
“If you are following the guidelines in place by the CDC and wearing a cloth face covering, there is very little risk of inhaling too much carbon dioxide,” said Sorenson. “This concern really only applies to health care providers as they wear tight, fitted N95 masks while providing patient care, treating those with communicable and highly contagious diseases.”
Remember that children under the age of 2, those that have difficulty breathing without a mask or are unable to remove one independently are not advised to wear a cloth face covering. This proactive measure is meant to be taken alongside the recommendations of maintaining a physical distance of at least 6 feet between people, refraining from touching your eyes, nose and mouth, and routinely washing your hands with warm soapy water for a minimum of 20 seconds consistently.
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