Coronavirus Face Masks & Protection FAQs
New information is emerging every day on how the new coronavirus spreads and the best ways to protect against COVID-19. The most effective protections include washing your hands frequently with soap and water and practicing social and physical distancing. However, wearing cloth face masks or coverings in public when social distancing can’t be observed does offer protection against spread of COVID-19.
Lisa Maragakis, M.D., M.P.H., an expert in infection prevention, provides guidance based on Johns Hopkins Medicine policy.
Should I wear a face mask or covering for coronavirus protection?
The answer depends on who and where you are. At Johns Hopkins, a team of experts in infection prevention, emergency medicine and emergency management is always reviewing the best ways to protect our patients, our staff and the general public. These are our current recommendations.
Masks for the Public
The general public: The virus can spread between people interacting in close proximity — for example via speaking, coughing, or sneezing — even if those people are not exhibiting symptoms. In light of this evidence, wearing a cloth face mask or covering in public places where social distancing can’t be observed will help reduce spread of the disease. For example, in a grocery store or on a bus, if you wear a face mask, you help protect those around you in case you cough or sneeze.
Federal and state agencies also provide specific recommendations:
- The Centers for Disease Control and Protection (CDC) recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (for example grocery stores and pharmacies), especially in areas of significant community-based transmission. Social distancing and taking precautions such as washing hands, using hand sanitizer and disinfecting surfaces frequently are also appropriate measures to avoid the spread of illness.
- Some states are now requiring face masks in retail stores and on public transportation. In Maryland, starting on Apr. 18, face masks or coverings will be required in retail stores and on public transportation.
People with higher risk factors for COVID-19: This would include people over age 65, and those living with heart disease, diabetes, chronic lung disease, immunity problems or cancer.
According to the CDC, since recent studies indicate a significant portion of people who have COVID-19 don’t show symptoms, the virus can spread before they realize they are sick. This new research — combined with the fact that the coronavirus can spread through close proximity to others, often via speaking, coughing or sneezing — led to their recommendation for the general public to wear cloth masks in public, especially where social distancing may be difficult and in areas of significant community transmission.
While social and physical distancing and frequent handwashing are the best ways to protect against COVID-19, you should check with your doctor about the best option for you. Johns Hopkins Medicine offers these directions for a homemade mask and child size masks, intended for use in non-patient care settings.
Masks for COVID-19 Patients and Their Caregivers
In order to protect from the spread of droplets, a surgical or cloth mask should be worn in a home setting by those with COVID-19 when they are around others. If the person who is ill is unable to wear a mask, their caregiver should wear one. Patients being treated in hospital settings will follow hospital guidelines.
Masks and Other Protective Equipment for Health Care Workers
Health care workers testing and treating patients for COVID-19: Anyone interacting directly with people ill or suspected to be ill with COVID-19 need professional respirators, such as N95 respirators, which are designed for medical use. N95 respirators fit the face snugly and filter the air to stop respiratory droplets from getting through or around the device. In addition, our care teams treating patients with COVID-19 wear added protective gear, including face shields that protect the eyes, nose and mouth from contamination from respiratory droplets, along with masks or respirators.
An important note about N95 respirators is that they are in high demand during this pandemic. It is crucial that they are only used by medical workers and first responders who have been fit tested to wear them so they can continue treating patients. Hoarding or diverting the use of these respirators could lead to serious harm to patients and medical staff.
Health care workers in patient areas, but not working directly with COVID-19 patients: Procedural, surgical and cloth face masks are being used to help guard against the possible spread of COVID-19. These masks don’t have a tight seal and are made of different types of materials.
Similar to influenza and other respiratory viruses, the virus that causes COVID-19 appears to be transmitted primarily through large respiratory droplets. Surgical or procedural masks provide protection against respiratory droplet spread.
While cloth masks are not medical-grade, they may be helpful in non-patient settings to contain coughs and to remind people to not touch their face, but they are not suitable for providing medical care to patients.
Read more about Johns Hopkins Medicine’s use of face masks in our care facilities.
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What are the different types of masks?
Called N95 respirators, these medical devices are made to prevent exposure to tiny droplets that can remain suspended in the air. Health care workers who wear them undergo a fit-test to find the right make, model and size to ensure a tight seal. The N95 respirators are currently in very short supply and should be reserved for health care providers and first responders.
Procedural and Surgical Masks
These are loose-fitting masks designed to cover the mouth and nose. Although they are not close fitting, they provide protection against larger respiratory droplets from coughs and sneezes. Like N95 respirators, it is critical that these masks are used by health care workers.
Cloth or Paper Masks
According to the CDC, these masks may help slow the spread of the new coronavirus, and help people who may unknowingly have the virus from transmitting it to others. While cloth masks are not medical-grade, they may be helpful in non-patient care settings to contain coughs and to remind people not to touch their face.
Can I make my own cloth mask?
Yes: Some people are making masks out of cotton or linen or even t-shirts or bandanas. There are several patterns available, including this one from Johns Hopkins Medicine and another for child size masks, for use in non-patient care settings. Cloth masks can and should be washed daily.
What items in my closet can I use to create a face covering or mask?
- Bandannas, scarves, hand towels, or any items made of cotton or linen are a good place to start.
- Thicker, more densely woven cotton fabrics are best, such as quilting cotton or cotton sheets.
- Stretchy knits aren’t ideal, since they allow more air in and out.
- Hold the fabric up to the light: The fewer tiny holes you can see, the better it will work to filter droplets.
- Overall, making a good mask involves finding a balance: You want fabric that doesn’t allow droplets to pass through while ensuring you can still breathe properly with your mask in place.
Can I create my own filter?
Some people buy or create masks with a pocket inside to hold a filter, such as a coffee filter. When using other materials to make your own filter, such as unused vacuum cleaner bags, HEPA furnace filters, HVAC anti-allergy filters or other air filters, make sure you sandwich the filter between at least two layers of fabric to cut down on the risk of inhaling potentially harmful fibers from these materials.
There are not yet conclusive data on whether or not filters provide added protection, but studies are underway. Please make sure that you can breathe easily when wearing the mask, and do not use a filter if it makes you feel short of breath.
What should I be looking for when buying a mask?
Look for masks made with at least 2 layers of fabric. It should cover your nose and mouth without large gaps. The mask should have ear loops or ties so you can adjust it. For people who wear glasses, look for a mask with a bendable border at the top so you can mold the mask to fit the bridge of your nose and prevent your glasses from fogging. Professional masks should be reserved for health care workers on the front lines caring for patients.
Remember, a mask does not make you immune from SARS-CoV-2, the coronavirus causing the current pandemic. Physical and social distancing and hand washing are the most important ways to avoid catching the illness. Wearing masks may offer some protection, but mostly prevents you from spreading droplets in case you are infected and have no symptoms.
Remember the best protections
In times of a pandemic, it’s understandable to want to do everything possible to protect yourself from becoming ill. While masks may seem like a good idea, remember that social and physical distancing, and frequent, thorough handwashing are still the very best ways to avoid getting COVID-19.
What you need to know from Johns Hopkins Medicine.
Updated: May 1, 2020