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Why do you need to wear a mask?

September 15, 2020
Published in: COVID-19, Infectious Disease

Staff wearing masks while working together at a computer

Because they work to slow the transmission of COVID-19.

Perhaps because the first advice was that it wasn't necessary to wear a mask. Perhaps because, culturally, Americans don't generally wear masks at other times, such as flu season. Perhaps because some just don't understand the benefit.

Regardless of the reason, many people around the country and around our community do not wear masks, or face coverings, when they should. The question many have is, "Why do I need to wear a mask?" The Infection Prevention staff at Augusta Health is happy to provide answers.

"I think there may have been confusion about wearing masks because the first recommendation was that the public did not need to wear them," says Stefanie Bartley, BSN, RN, Infection Prevention Specialist at Augusta Health. "In the beginning, there was a legitimate concern about the limited supply of surgical masks and N95 respirators, and whether there would be a large enough supply for the healthcare workers who desperately needed them. However, as researchers learned more about how highly contagious the virus is, the recommendations changed, and the public was advised to wear cloth coverings when in public."

"As we learned more about the disease and it became much more prevalent in our communities, we learned that both pre-symptomatic and asymptomatic transmissions are possible and even fairly common," adds Allison Baroco, MD, Infectious Disease physician at Augusta Health, "Which means we can't actually tell who is infected. A simple conversation is enough close contact to transmit the virus, so it's very important for everyone to wear a mask when they'll be within six feet of others. There's a lot of asymptomatic transmission. Wearing a mask is important to stop that."

"Masks are a simple and effective way to protect one another from the spread of COVID-19," says Tracy Sansossio, BSN, RN, another Infection Prevention Specialist at Augusta Health. "Wearing a mask not only protects the person wearing the mask, it also protects other from their respiratory droplets. When the mask is worn correctly, covering the nose and mouth, the mask contains or "catches" the droplets from spreading to someone else when closer than the six foot social distance. As Dr. Baroco mentioned, we have the ability to transmit the virus days before you have symptoms. The combination of wearing a mask, maintaining social distance and avoiding large gatherings is our best defense against COVID-19 until a vaccine becomes available. Just like stopping at a stop sign or wearing a safety belt, wearing a mask is something we can all do that will benefit everyone to help reduce the spread of COVID-19."

There is also a misconception is that being outdoors stops COVID-19 transmission. While being outdoors provides some 'ventilation', the virus can still be spread to others through, again, something like a 15 minute conversation. So, even if you're outdoors, social distancing and masking are still needed to stop the spread of the virus.

There is good evidence to support the effectiveness of masks. Some older studies, done with flu as the focus, found that masks did block droplets. A recent study in Health Affairs compared COVID-19 growth rate before and after mask mandates in 15 states and the District of Columbia. Five days after the mandate, the daily growth rate had slowed by 0.9 percentage points compared to five days before the mandate. At three weeks, the daily growth rate had slowed by 2 percentage points.

Stories in the news also illustrate the effectiveness of masks. In one story, a man flew from China to Toronto and then tested positive for COVID-19. He had a dry cough on the flight, but wore a mask. When the 25 people who were closest to him on the flight were tested, they all tested negative. Another story in May involved two hair stylists in Missouri who were in contact with 140 clients while they had COVID. Masks were required in the salon for both stylists and customers. None of the 140 clients tested positive.

The best mask to wear is the one that can be worn consistently, and that choice varies by personal preference. Many find surgical masks lighter and more comfortable than hand-sewn cloth masks. Medical N95 respirators are only needed in medical situations. The N95 masks with valves that are commonly purchased in home improvement stores are not recommended. Their design is that the valve closes when the wearer breathes in (to protect from fumes and chemicals) and opens when the wearer breathes out. That allows droplets to escape, and is the opposite of what is needed to stop the spread of COVID-19.

"As a community, we can protect each other from spreading COVID-19 three ways—washing our hands, socially distancing and wearing a mask," says Dr. Baroco. "While doing any of these prevention activities helps, the best course of action is to do all three."