Is Double-Masking Needed to Prevent Transmission of COVID-19?

Part of the new normal of pandemic-living includes wearing a face mask in public in order to protect yourself and those around you from COVID-19. Face masks are face coverings used as a protective measure against respiratory droplets (spread by people talking, sneezing, and coughing) that can contain COVID-19. Now, a new question has arisen: is double-masking needed for COVID-19? In this blog post, we address what the experts and best practices suggest around wearing two masks.

What the experts say: Are two masks more protective than one?

While the CDC recommends masks with at least two layers, it can be difficult to determine the quality of a given mask which is affected by the type of material used, the thickness of the material, et cetera. To combat this uncertainty, Dr. Monica Gandhi, an infectious disease expert at the University of California, San Francisco, recommends wearing a surgical mask with a cloth mask because the combination can be as effective as an N95 mask. According to Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, wearing two masks versus one “likely does” offer more protection. “So if you have a physical covering with one layer, you put another layer on, it just makes common sense that it likely would be more effective,” said Dr. Fauci in January 2021 on the NBC News Today Show.

Linsey Marr, an expert in virus transmission and professor of civil and environmental engineering at Virginia Tech said, “A mask is like an obstacle course for particles to get through.” Therefore, wearing a second mask “increases the chance that the particle will be trapped before it gets through.”

Why should someone consider wearing two masks?

According to the Johns Hopkins University of Medicine Resource Center, as of February 8, 2021, COVID-19 has infected more than 106 million people globally, including  27 million in the U.S. The Centers for Disease Control and Prevention (CDC) estimates that people who are asymptomatic or presymptomatic—those who feel well and aren’t aware that they might be infecting others—could be causing more than 50 percent of the transmissions. Although there’s no official CDC guidelines about double-masking, wearing two masks when you have to spend more time around other people—public transportation, indoor gatherings, and airplanes—is a simple way to potentially lower your risk of contracting COVID-19 and unknowingly spreading it to others.

As of February 8, 2021, 32 million people in the U.S. have already received at least one dose of a coronavirus vaccine, and 9 million people have been fully vaccinated. However, it will be some time before everyone is fully vaccinated, so the best approach is to practice a combination of wearing masks, social distancing, and good hygiene. As Jennifer Nuzzo, a public health expert at Johns Hopkins University says, the best response to the pandemic is one that requires multiple interventions.

Mask wearing doesn’t mean we can forget about social distancing or vaccination, but it does help block transmissions between infected people and their close contacts by up to 79 percent, according to a study in Beijing.

Early in his presidency, President Biden signed a mandate for all federal workers and those on federal property to wear face masks, in addition to people riding buses, trains, and airplanes. This includes wearing masks in airports.

With the new strains of COVID-19 emerging across the globe and the soaring numbers of new COVID-19 cases, experts recommend not only wearing two masks, but also reconsidering the quality of the masks themselves.

Best masks for COVID

Below are some of the best masks for COVID according to health experts.

N95 masks

N95 masks are a type of respirator that offer the most protection against both large and small particles. As the name indicates, N95 masks block 95 percent of very small particles. While N95 masks are the most effective, best masks for COVID-19, the CDC has asked the general public not to wear N95 masks, since these masks should be reserved for medical first responders and healthcare professionals.

The N95 masks, like surgical masks, are meant to be disposable, although due to their short supply, researchers are looking for ways to disinfect them so they can be used more than once.

Surgical masks

Surgical masks are loose-fitting, disposable masks that create a physical barrier between the nose and mouth of the wearer and potential contaminants in the environment (such as droplets) when an infected person coughs, talks, or sneezes next to someone else. Unlike N95 masks, surgical masks cannot filter very small particles nor do the edges of surgical masks form a tight seal around the nose and mouth. While surgical masks are perhaps not as effective as N95s, they are thought to be the second best option when it comes to blocking large particles and respiratory secretions. A surgical mask shouldn’t be used more than once, and if damaged, or if breathing through it becomes difficult, you should remove the mask and replace it with a new one. 

Like N95s, surgical masks should first be reserved for healthcare workers and medical first responders, so please avoid stocking up on surgical masks and/or first consider using a cloth mask.

Cloth masks

Cloth masks, as with all face masks, are intended to block droplets released when the person wearing the mask (or those surrounding them)  speaks, coughs, or sneezes. 

Cloth masks are easy to make or purchase and they can be reusable if properly disinfected after each use—you can even make them from an old T-shirt or bandana. For a cloth mask to be effective to protect you against COVID-19, the CDC recommends that people use masks that have two or more layers made with breathable, tightly woven fabric such as cotton and quilting fabric. Research shows that multilayer cloth masks with higher thread counts offer more protection than single-layer cloth masks with lower thread counts, and can block up to 50 to 70 percent of fine particles and droplets, limiting the spread of COVID-19.

The CDC recommends that people avoid cloth masks with exhalation valves or vents because, while these features may make it easier to breathe, they may not be as effective in preventing the spread of COVID-19 to others.

How to wear a face mask properly

Wearing a face mask doesn’t automatically protect you from getting infected, especially if you don’t wear the face mask properly and aren’t following other important guidelines, such as social distancing and frequent hand-washing. 

When selecting and wearing a face mask, the CDC recommends the following “do’s and don’ts”:

Do:

  • Choose masks that have two or more layers of breathable fabric. 
  • Cover your nose and mouth completely, and secure the mask under your chin. 
  • Make sure your mask fits comfortably against the sides of your face without any gaps.
  • Wash your hands with soap and warm water or use hand sanitizer before you put on your mask and after you take your mask off
  • In colder weather,  wear a mask under your scarf.
  • Have a spare mask with you as a backup should the first mask get wet. .
  • Store wet  masks in a plastic bag until you can wash them. 
  • If wearing glasses, look for a mask that fits closely over your nose or that has a nose wire you can adjust to reduce fogging. Anti-fogging spray might also do the trick.

Don’t:

  • Wear masks made from material that is hard to breathe through, such as vinyl or leather.
  • Choose masks that have exhalation valves or vents that could allow particles to escape. 
  • Use masks that are reserved for healthcare workers, like N95 respirators and surgical masks. 
  • Use masks that don’t fit properly, whether from large gaps or being too loose or too tight.  
  • Wear masks with one layer of fabric. 
  • Put the mask around your neck or up on your forehead.
  • Touch the outer side of your mask. If you do, wash or sanitize your hands.

Special considerations for those not wearing a face mask

There are a few categories of people who aren’t advised to wear face masks. They include:

  • Children under 2 years old
  • Those who have trouble breathing (i.e. due to underlying health conditions)
  • Anyone who is unconscious or incapacitated
  • Wearing a mask can be difficult for people with sensory, cognitive or behavioral issues. If they don’t tolerate a mask or are unable to wear it properly, they shouldn’t wear one, but should keep distance from others, practice good overall hygiene, and wash their hands frequently.

How to take off your mask properly

When taking off your mask, the CDC recommends following these steps:

  1. Carefully stretch the ear loops of your mask or untie the strings behind your head. 
  2. Handle your mask only by the ear loops or ties. 
  3. Fold the outside corners together. 
  4. If disposable, properly dispose of the mask. If not, put it inside a plastic bag or in your washing machine.
  5. Do not touch your eyes, nose, and mouth when removing your mask.
  6. Wash your hands with soap and water immediately after removing.

*It is important to properly dispose of your mask as, should it be set down somewhere, the next person to pick up the mask is then exposed to the bacteria/viruses on your mask.

At the end of the day, wearing two masks or just one mask doesn’t replace other strategies such as social distancing, accurate testing, and proper hygiene. Rather, it is a combination of all of these that can help flatten the curve and end the pandemic. Whether or not you decide to use two masks, the benefit of wearing at least one face mask increases as more people use masks properly and consistently.
If you suspect you might have COVID-19, the Curative COVID-19 test takes only 20 seconds to swab the mouth and collect a sample. Observed and directed by a healthcare worker.

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