You should wear a mask to protect yourself against COVID-19, period. This article explains why and how to wear a mask safely. It also addresses advice you might have read or heard about that differs and how to make sense of this information.
First of all, I write this article with a heavy heart as two people in my family now have COVID-19, one not yet 60 and the other over 85. I’ll never know if wearing a face mask could have protected either of them, but the research shows that it’s more than likely a mask could have helped.
April 2nd update: Both family members recovered beautifully with the help of Chinese medicine natural remedies for Covid-19! Also, the U.S. government finally says people should wear masks. Please DO NOT follow their advice about wearing fabric masks. You can learn more below!
We need to remember that COVID-19 is so strong and good at infecting people! Even better than wearing a mask is the advice to STAY HOME!
That being said, we cannot always stay home. As a result, you should wear a mask when you have to go out.
A quick thank you to the photographer, Emma Cueto, for her sensitive and beautiful photographs of people wearing masks in Shanghai during day-to-day life living under COVID-19. Visit her website to see more of her thought-provoking photos.
I am fortunate to be able to sell masks at my cost for the mask plus shipping materials. A friend of mine from China, who I contacted to interview for the article, is importing KN-95 masks into the United States and asked if I could get them to people who need them. If you need masks, you can learn more about the masks and order by clicking the product button below.
My personal experience with wearing a mask
When I lived in Shanghai I was a “crazy” wei guo ren 外国人 (outsider/foreigner) who wore a mask on days with a pollution index over 200. That’s some dirty air!
Many of my western colleagues also wore masks on those days, but none of my Chinese colleagues or people I saw around me wore masks to protect against pollution.
When I asked my Chinese friends why, they said that they knew they would be fine. Their lungs were strong from their healthy lifestyles and could fight the effects of the pollution.
I asked my Chinese friends when and why they DID wear a mask.
Everyone replied with two key reasons:
- to protect other people from their germs when they were sick, and
- to help if they had allergies, because they believed allergy medicines were harmful.
However, with the outbreak of COVID-19, all my friends, doctors and non-doctors alike, said they wore a mask to keep others AND themselves safe.
Not only that, once they heard the virus reached the United States, they wanted to make sure that I am wearing a mask whenever I go out.
Now I’m the crazy American wearing a mask and being judged at home as well. I wanted to understand why.
Why people are being told not to wear masks in the west
Due to their cultural values to protect others, people in China and other parts of Asia wear masks as a courtesy when they are sick.
During the COVID-19 outbreak, they have also been wearing them to protect themselves, and the health outcomes have been positive.
After reading numerous articles and government warnings, as well as talking with friends in the western medical establishment, I have identified three main reasons people are being told not to wear protective masks.
- People do not know how to put on and take off the masks safely and could put themselves at greater risk for infection.
- People might wear the wrong type of mask and believe they are protected, when they are not.
- There are not enough FDA certified N-95 masks for everyone to wear and still have masks available for healthcare workers, first responders, etc.
The first two items can and should be tackled through public service announcements. Since masks keep people safe, and you should wear a mask, the government should invest the time and resources necessary to teach you how to use masks properly.
Vietnam, for example, put out a hugely popular public service announcement about how to wash your hands properly. The same thing could be done in the United States for how to properly wear a mask.
Maybe the government chooses not to educate people because there are not enough masks to go around. Officials need to save masks for healthcare workers. That’s totally fair and reasonable.
If you can find masks to wear to keep yourself safe, please do so!
Remember! We all:
- are going to have to buy groceries
- might have to go to the doctor, the dentist, or the post office
- might have to sit across a conference table for a meeting or go to court.
Because you will most likely have to leave your home, you should wear a mask at these times. As my Chinese friends tell me, please keep yourself safe and wear your mask!
Why people might be afraid to wear masks in the west
I am not going to write about the xenophobia and shaming that goes with wearing a mask in the United States and other western countries. I am going to recommend two articles that capture the problem beautifully.
The first is written by a young Asian woman living in the United States, Connie Wang. She discusses the racism she’s faced wearing a mask and explores why it’s confusing and hurtful to her in her article “What it Means to Wear a Face Mask in America”
The second is a recent article in Time magazine by Hillary Leung writing in Hong Kong. In the article, Leung compares Asian and western perspectives on wearing a mask.
Both articles discuss the racism and shaming in the United States towards people who wear masks.
We need to stop these reactions because masks make a difference.
In Leung’s article, she interviews Dr. David Hui, a respiratory medicine expert at the Chinese University of Hong Kong. Dr. Hui studied the 2002 to 2003 SARS outbreak and says that it’s “’common sense’ that wearing a mask would protect against infectious diseases like COVID-19.”
The right masks are effective
Dr. Hui also states that, “If you are standing in front of someone who is sick, the mask will give some protection.” Hui also says, “The mask provides a barrier from respiratory droplets, which is predominantly how the virus spreads.”
While Dr. Hui has this information from his work with SARS and later lab research, he makes another great point that researchers cannot do randomized studies on humans. Having some subjects wear a mask and others not, while exposing them to a coronavirus, would be unethical.
A tale of two card games
Interestingly, that is exactly what a group of researchers did to themselves! This group ran two experiments, definitely not as a controlled trial but out of curiosity and to advance their work in the lab.
The scientists played two games of cards around a table. The people in the first game were NOT wearing masks.
They sat playing cards for less than an hour. One of the people had been infected with a coronavirus (not COVID-19 because it didn’t exist in the human population yet). The idea was to see if anyone could catch the virus just sitting around the table. EVERYONE contracted the virus.
The people in the second game played with an infected person but DID wear masks. No one contracted the virus.
Advice about masks from virologist Dr. James Robb
Many of you have probably already read the advice of Dr. James Robb. If you haven’t, he began researching coronaviruses back in the 1970s and continued his work through the SARS and MERS epidemics, both from different animal sources.
Dr. Robb recommends five steps to take during influenza season that are important to follow now as well. Because COVID-19 is so virulent, he offers TWO additional steps – wearing gloves and a MASK.
Here’s why Dr. Robb recommends a mask. Masks prevent you from touching your nose or mouth. This is the only way the virus can infect you, because it is lung specific.
He explains that people touch their faces, especially their nose and mouth, 90 or more times a day without knowing it!
Why fabric masks are not safe
Surgical masks or light weight masks without a full face seal offer the protection Dr. Hui describes above. The ability of a mask to prevent you from touching your face, as described by Dr. Robb is another benefit of these masks.
Not touching your face is the only benefit of a fabric mask!
The fact is, if a droplet lands on the fabric, the mask CANNOT protect you and might put you at risk because the virus can then penetrate through the fabric. Simple surgical masks have a moisture proof barrier.
No research has been done on adding waterproof coatings to fabric masks. So many questions arise with no answers. A couple of questions are:
- Does the waterproof barrier repel or attract the droplets?
- How long would it take for the droplets to penetrate if the surface cannot repel them?
Proper masks provide the protection you need
A N-95, KN-95, or equivalent certified masks can provide added protection against a direct sneeze. A surgical mask will keep you from touching your nose or mouth. These masks have undergone rigorous testing. You have the time necessary to remove and dispose of the mask safely. Please buy proper masks to keep you and your family safe.
How to put on, remove and dispose of a mask properly
The San Francisco department of public health has a great page on how to use a mask properly. For the purpose of this article, I’m listing the step-by-step guide they suggest.
How to put on a face mask
- Clean your hands with soap and water or hand sanitizer before touching the mask.
- Remove a mask from the box and make sure there are no obvious tears or holes in either side of the mask.
- Determine which side of the mask is the top. The side of the mask that has a stiff bendable edge is the top and is meant to mold to the shape of your nose.
- Determine which side of the mask is the front. The colored side of the mask is usually the front and should face away from you, while the white side touches your face.
- Follow the instructions below for the type of mask you are using.
- Ear loops: Hold the mask by the ear loops. Place a loop around each ear.
- Ties: Bring the mask to your nose level and place the ties over the crown of your head and secure with a bow.
- Bands: Hold the mask in your hand with the nosepiece or top of the mask at fingertips, allowing the headbands to hang freely below hands. Bring the mask to your nose level and pull the top strap over your head so that it rests over the crown of your head. Pull the bottom strap over your head so that it rests at the nape of your neck.
- Mold or pinch the stiff edge to the shape of your nose.
- If using a face mask with ties: Then take the bottom ties, one in each hand, and secure with a bow at the nape of your neck.
- Pull the bottom of the mask over your mouth and chin.
How to remove a face mask
- Clean your hands with soap and water or hand sanitizer before touching the mask. Avoid touching the front of the mask. The front of the mask is contaminated. Only touch the ear loops/ties/band. Follow the instructions below for the type of mask you are using.
- Ear loops: Hold both of the ear loops and gently lift and remove the mask.
- Ties: Untie the bottom bow first then untie the top bow and pull the mask away from you as the ties are loosened.
- Bands: Lift the bottom strap over your head first, then pull the top strap over your head.
- Throw the mask in the trash. Clean your hands with soap and water or hand sanitizer.
Because you should wear a mask safely, I’m also sharing a cute and easy-to-follow video from Dr Ernest Poh, a chest physician from the University of Malaya Medical Centre.
Remember that COVID-19 is an easily transmittable virus. Avoiding the virus is your best way to stay healthy. Ideally, stay home.
If you have to go out, you should wear a mask to keep your hands off your nose and mouth. Any surgical mask will help you accomplish this goal.
You might also want the extra layer of protection afforded by a KN-95 mask, which will protect you from droplets long enough for you to remove the mask and dispose of it safely.
How to stay healthy
We have a great post about how to stay healthy against COVID-19 (coronavirus). Learn more.