woman in yellow tshirt and beige jacket holding a fruit stand

Should I be wearing a face mask when I go out?

Question: I’ve been reading a lot lately about face masks. Should I be wearing one when I go out?

Answer: This issue has evolved so much over the last few weeks, including since I wrote about face masks in my Q&A of 3/20. So, what’s the current word? First, guidelines vary dramatically by country. Here in the United States, CDC’s guidance remains the same as I described it back on 3/20. However, CDC is now reviewing its guidance in light of increased evidence of substantial asymptomatic and pre-symptomatic spread. As a reminder, CDC’s current mask-wearing guidance advises ill people to wear masks, but does not advise well people to wear them. Such guidance is perplexing in the context of COVID-19 — when a person is asymptomatic or pre-symptomatic, they would incorrectly classify themselves as a “well person,” and would then be walking around without a mask, unknowingly spreading illness. Upshot here is== when it comes to protecting yourself, your family, and your community, there’s absolutely nothing to lose in wearing a homemade mask to go out into the world (except for maybe some side-eye at the grocery store, but in this crisis, who cares!?!) and potentially lots to gain in terms of reducing virus spread. Now, there’s one big caveat here — with N95 masks and surgical masks in short supply, we need to save those for the doctors and nurses. This means that we need to make and use homemade masks (more on that below).

Question: I want to help! What’s the best way to make masks for myself, my family, doctors and nurses? Can surgical masks I make help health workers even though they aren’t N95s?

Answer: Awesome! I love the can-do attitude. And with personal protective equipment in short supply, every bit we can do can help. Unfortunately, we don’t have guidelines from CDC or other federal health officials for how best to make masks for health workers and others. I have seen LOTS of directions online, like this DIY published in the New York Times today and this post from Vanderbilt University Medical Center, which also offers step-by-step instructions. Good news is — for the most part, surgical masks appear to be nearly identical to N95 masks when it comes to health worker protection against respiratory illness. More specifically, a literature review from Center for Evidence Based Medicine updated just yesterday states, “Standard surgical masks are as effective as respirator masks (e.g. N95, FFP2, FFP3) for preventing infection of healthcare workers in outbreaks of viral respiratory illnesses such as influenza. No head to head trial of these masks in COVID-19 has yet been published, and neither type of mask prevents all infection. Both types of mask need to be used in combination with other PPE measures. Respirator masks are recommended for protection during aerosol generating procedures (AGPs). Rapid reviews on wider PPE measures, and what counts as an AGP, are ongoing.” This means that the masks you make at home — if well made — can do the job! Now we just need CDC on the case to give us the best guidance for how to make the most effective masks!