Ask Us Anything About… Wearing a Mask

A woman sits on a bus, with her left arm resting on the window rail. She looks out the window. She's wearing a surgical mask.

The Centers for Disease Control and Prevention recommends that people wear face coverings in public settings when around people outside of their household, especially when other social distancing measures are difficult to maintain. Wearing a face mask is a simple way to help slow the spread of COVID-19 but there is a lot of misinformation about wearing a mask. Learn more from Dr. Jessica Ericson, pediatric infectious disease physician at Penn State Health Children’s Hospital.

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Scott Gilbert – Well, hello and welcome to Ask Us Anything About Wearing a Mask from Penn State Health. I’m Scott Gilbert. Thanks so much for tuning in. This is the 75th edition of Ask Us Anything About here on Facebook from Penn State Health. As we mark the occasion, we’ve changed the look of our interviews, as you might have noticed. And this is in order to keep everybody safe, because as we returned from a bit of a hiatus, you’ll notice we’re using the platform that allows us to talk with our subject matter experts from a distance. But as with the previous 74 programs, we of course, welcome your questions throughout the interview. Today, the topic is wearing a mask. With the spread of COVID-19 so far from under control, masking is among the key steps we can take to limit the spread of this highly contagious disease. It’s also the subject of a recent order from Dr. Rachel Levine, Pennsylvania Secretary of Health. We’re going to tackle the do’s and don’ts of wearing a mask and take as many of your questions as possible with Dr. Jessica Erickson. She’s a pediatric infectious disease physician, also an epidemiologist at Penn State Health Children’s Hospital. Dr. Erickson thanks so much. It’s good to have you with us today. I’d like to start with the different types of masks that are out there. You know, there are surgical masks. There are N95s, they’re handmade cloth masks. Does it make a difference the type of mask someone wears?

Dr. Jessica Ericson – Yes, it does. So the N95 masks are going to be difficult for most people to wear for long periods of time. In general, we still want to be saving these masks for our frontline health care providers, because they are still in fairly short supply. And they’re really more than is necessary for most everyday interactions for most people. The surgical masks are lightweight, easy to wear, they’re certainly more abundant, but for everyday use across the whole population they’re probably going to end up – they would be at risk of being in short supply too. So for everyday use, the cloth masks are becoming the go to mask, but these really vary quite a lot depending on what kind of material they’re made out of. [Inaudible] is made up of a pretty tightly woven fabric. As you can see through it, it’s not going to keep the germs out of the air, which is really the whole point of the masks. So for everyday use, either a surgical mask or a cloth mask that’s made of a sturdy, tightly woven fabric like cotton, quilting fabric is going to be the best bet.

Scott Gilbert – Sure than, people may say, well, you know, I really want to wear something that both protects me, but is also breathable. So are some of those more breathable type of masks or fabrics just as effective as something that might be less so?

Dr. Jessica Ericson – So it really depends on how many the layers are, and for the most part, the answer is no. For the most part you don’t want it to be breathable in the scent. You want air to be able to get through it, of course, but you really do want some of those tighter woven fabrics. Wilting cotton is going to be, you know, the best fabric to use. Something that’s more like a spandex or a stretchy kind of athletic wear tight fabric is not going to be as protective as a sturdier fabric is.

Scott Gilbert – So in terms of where to wear a mask, I think there’s some places it’s obvious we need one, right. When we go into say a store, a business, and then places where it’s perhaps more obvious that we don’t need it. Like, here I am alone in my own home in my home office I’m not wearing one now for obvious reasons. But then there’s some other types of areas where people may wonder, should I wear a mask? So let’s go through a few of those. How about let’s say I go outside to take a walk in my neighborhood, should I be wearing one then if I walk down the street? I might be walking by other people occasionally.

Dr. Jessica Ericson – I would say probably not. It depends on how densely populated you [inaudible] particular neighborhood is. Where you’re going to be people on the sidewalk a bit of time, then wearing a mask would be a good idea. If you live in a more rural or suburban neighborhood where you might pass one person the whole time you’re out walking, then it’s [inaudible] or there’s room for you’re away from the other people that you’re passing, then a mask is probably not necessary when you’re just outside walking around.


Scott Gilbert – You’re watching Ask Us Anything About Wearing a Mask from Penn State Health. It’s good to be back on with our programs after a brief hiatus. You may have noticed here we have a new platform we’re using to allow us to continue to connect with our subject matter experts about a range of important topics. Today is with Dr. Jessica Erickson. She’s a pediatric infectious disease physician, also an epidemiologist at Penn State Health Children’s Hospital. We’re glad to have her. We’re glad to have you watching, so feel free to add your questions to the comment field below this Facebook post, and we can post them live. Dr. Erickson, we’re talking about the various places when people should and shouldn’t wear a mask. So what about some of the other places that, you know, may, you know, people may not think of, but they should definitely be mindful of wearing a mask when out in public?


Dr. Jessica Ericson – I think you should definitely take one along, have it in your pocket or your purse, ready to wear. If you’re going to it may or may not be a lot of people around. A place like the zoo [inaudible] and wearing a mask is the kind, and you get [inaudible] then it would probably be using [inaudible]. Buying your ticket when you’re interact with people in the gift shop, then that match should go back on further protection of those clerks that you’re interacting with.


Scott Gilbert – Some people may say, you know, who should wear a mask? Is it just something that older people should wear? Should just younger people wear one to protect older people or should everybody wear one essentially?


Dr. Jessica Ericson – Well, I would say every one essentially should. The main exceptions to that are people who are unable to take the mask off by themselves. So young children, we’re generally saying younger than two years old. People who are – have some kind of disability where they would be unable to take the mask off in an emergency. Those people should not be wearing masks, or people who have a significant respiratory problem, like COPD, emphysema. A breathing problem where, you know, even the teeny tiny, generally insignificant amount of air flow restriction you [inaudible] a big deal. And that’s going to be a pretty small percent of people. Most people should wear a mask. And we need to remember that the point of wearing a mask is to protect other people. You get a little bit of benefit in protection for yourself. But the main point of wearing a mask is to protect the store clerk who has cancer. The neighbor boy who has asthma. The grandmother [inaudible] so realizing that you don’t know the risk that those people around you might be experiencing, because you’re not wearing a mask. Even if you’re a low risk person who probably won’t have a problem if you get COVID, wearing a mask keeps you from accidentally giving it to your friends and neighbors for whom it would be a significant problem.


Scott Gilbert – We want to welcome you to – add your questions to the comment field here just as Joanna has done. She’s asking us what is the best way to clean reusable face masks. So especially like those cloth masks like we talked about before, Dr. Erickson, what do you recommend?


Dr. Jessica Ericson – Really the best thing is to wash them in the washing machine. You know, with your towels, with your underwear, generally in hot water, but using good detergent. In general, it’s good to wash after each use, because you may have encountered germs from other people in the air that are now on the outside of that mask. So get you all a set, you know, five or 10 of them that match all your favorite outfits. And then you’ll just every time you’re going out for each day, throw it in the wash like you would your underwear at the end of the day.


Scott Gilbert – Great advice. You know, when it comes to outside versus inside, is there a different, is there an enhanced risk of spread inside versus outside where say the wind may be blowing, and we might be in a more open space, and Is that why maybe there are some differences in some of the guidelines that are out there from federal and state authorities?


Dr. Jessica Ericson – Yes, that’s absolutely the case. So in a building, or, you know, if we take it to the extreme, like an airplane where that same air is in that room, so to speak just sitting there for a couple hours, you know, eventually everyone’s breathing all that same air. In a small room that would similarly be the case. And as the room gets bigger, and the air gets turned over by the air conditioner, or by windows, that’s going to dilute out a lot of those germs. So then we take it to the extreme of [inaudible] germs are going to be blown away by the wind before they have a chance to be breathed in by the next person. You also have the extra benefit of sunlight at least this time of year, and, you know, sunlight access a great disinfectant with that, you know, the UV light, so we get kind of those two benefits of being outside.


Scott Gilbert – Sure. Some people who are rather skeptical of the most recent guidelines for wearing masks might point to the, I guess you’d say early days of COVID-19, February, March around that time, when the guidance seemed to be different. When it seemed like authorities were saying no need to get a mask, just leave the masks to the health care workers. But now the guidance is different. Perhaps it was because aerosol and droplets were first thought not to be a big deal. But can you talk about how that thinking has evolved, and why people who may be skeptical of the new guidance should adhere to it?


Dr. Jessica Ericson – Sure. In full disclosure I was a mask skeptic, myself. We’ve had a few studies looking = show that mask wearing doesn’t seem to make a big difference. But as we’ve learned more and more about Coronavirus and COVID-19, it’s pretty clear that masks do make a big difference in spreading it among populations. You know, when we look at like a whole state for instance, states that wear masks are doing better. Countries that wear masks are doing better than countries that don’t. And [inaudible] more about how this virus is spread from one person to another it’s become very clear that masks are one of the most effective ways we have of preventing its spread. So from a former mask skeptic, it’s really the best thing that we can do at this point, and there’s really no reason not to wear a mask.


Scott Gilbert – You’re watching Ask Us Anything About Wearing a Mask from Penn State Health. Thanks so much for the comments and the questions. Keep those coming. And included there’s some very nice comments for you, Dr.Erickson, so I think you’re going to want to go in and read those later. You have some fans in the comments section here. We welcome your questions. So feel free, again, to add those in the comment field. And we’ll pose those to Dr. Erickson here as we try to get out the right information here about the importance of wearing a mask to help mitigate the spread of COVID-19. When we talk about, let’s say – I was at the mall over the weekend. I was at the grocery store over the weekend, and nearly everyone I saw had masks on, but a lot of people were doing this. They were wearing them like this, below the nose. And so what is the importance of covering not only the mouth, but also the nose, and making sure it’s high enough? Is it effective still if it’s even just over the mouth?


Dr. Jessica Ericson – So wearing a mask over your mouth is going to be much more effective than not wearing a mask at all. That’s going to take care of droplets that would get into the air from pocket. If you’re the sort of person that when you talk, you [inaudible] sit a bit, that’s going to keep those droplets from your mouth from getting into the air. But, of course, you can get droplets into the air from your nose, especially when you sneeze, or, you know, you get a little bug in your nose and you have to sniff, those sorts of things. Wearing a mask with and your mouth is going to be the most effective. For situations where that mask is doing a little bit to keep you from getting germs from other people, having it over your nose is also going to be more helpful for your own personal benefit to, you know, so if over your nose and mouth wearing a mask over your mouth is better than nothing. But really it’s better for everyone if you can wear it over both your nose and your mouth the way they’re designed to be worn.


Scott Gilbert – Sure thing. We have a question from Sandra now. She’s asking, because she has behind the ear hearing aids. Would [inaudible] pass for the mask rule? In other words, you know, would if she was to wear – I believe she’s talking about the kind of plastic face shield that comes out and about around the face. Can you talk about the protection afforded by a face shield versus a mask and what the difference is there?


Dr. Jessica Ericson – Yeah, that’s a great question. So wearing a face shield gives you [inaudible] doesn’t do. However face shields it’s easier for droplets to come around the face shield, and then get to your face and mouth, or similarly from you for your cough to go out around the bottom or the sides of the face shield. So that’s one problem with it. The next is actually [inaudible] pretty difficult to wear a face shield, or they generally sit around the head like this. And, you know, they’re kind of more prone to move up and down. They’re a little less comfortable for [inaudible]. It’s harder to keep them clean and maintain them over a long time where the cloth mask, for instance, you can just throw in the washer and use them repeatedly. So one thing that you could try would be getting a like a headband. There are some very nice ones made of, you know, spandex, some stretchy materials, sports bands, and then put some buttons on those. You can even buy these sorts of headbands now, and then you can put the mask straps on those buttons on your headband. Or if you have a little hat, like I have here, put them on there. And then that is attached to your head without having to have it go right behind your ears. So that would be one thing to try. Certainly a facial —


Scott Gilbert – Yeah, that’s great.


Dr. Jessica Ericson – is better than nothing. So it kind of [inaudible].


Scott Gilbert – Sure, sure, that makes good sense. We welcome your questions for Dr. Jessica Erickson. Please feel free to continue to add those in the comment field here below this Facebook post here on Ask Us Anything About Wearing a Mask from Penn State Health. How about storing a mask? You know, whether it is a cloth mask or a surgical mask, what’s the best way to store it when I’m not wearing it? I know I shouldn’t just shove it in my pocket, right?


Dr. Jessica Ericson – Yeah. So your main goals are going to be to keep the mask clean so that then when you put it on your face the next time you’re not putting germs or dirt than up on your face. So a good strategy is to have like a paper sandwich bag where you can slide the mask in where while you’re storing it. I’ve also seen, like my brother has this nice little key rack next to the door where they have their clean masks hanging so they’re ready to grab when they leave the house. So your main goal is going to [inaudible] keep it clean and dry until you’re ready to use it.


Scott Gilbert – So there’s a lot of information out there, especially on social media about wearing a mask and there even full memes out there about listing this supposed dangers of wearing a mask. That’s why I think it’s so important that people get information from the right place. So do you have any recommendations as to the best places where people can turn most reputable sources for information about this that, you know, may or may not include social media?


Dr. Jessica Ericson – Yes. So this CDC is a good place to go. And I know that you’ve already mentioned that they’ve kind of gone back and forth with the mask advice. But I see that really as a reflection of their willingness to, you know, incorporate new information, and these new guidelines shouldn’t really be taken as, you know, a negative. But as new information is coming out, they’re responding to that with new recommendations based on the best and most current information that we have available. So that would be one place. You know, most hospitals have some information that’s written for the public and is easy to understand. And then some of the health organizations for whatever type of person you happen to be. For instance, I’m a pediatrician, so we have the American Academy of Pediatrics, the AAP, and they certainly put out a lot of good information for parents and school teachers, anyone who interacts with young children. And there are similar corresponding agencies focused on older adults, people with cancer, you know, varieties of groups.


Scott Gilbert – What about the importance of wearing a mask in conjunction with other safety steps? I mean, things like social distancing, and hand hygiene. I mean, those are still important, right?


Dr. Jessica Ericson – Absolutely. Yes. So none of these measures is 100% effective. So if you hear somebody say, hey, I was wearing a mask. I know somebody who wore a mask and they still got sick. You’re not [inaudible] because none of these, the six foot rule comes from the, when a person is talking or coughs, most of their droplets will usually not go farther than six feet. But most of the time usually includes that sometimes they’ll go further than that. So wearing a mask, and also trying to stay six feet away from people kind of lets you take advantage of the benefits of both of those ways of protecting and your loved ones. And good hand washing when you’re touching things, when you’re touching things at the store. You know, the best way to handle that is to be washing your hands on a regular basis. And certainly before touching your face or putting your mask on or off.


Scott Gilbert – Sure thing. Are there, you know, there is some supposed information out there about masks restricting people’s ability to breathe. So there’s some things out there about it can reduce your oxygen intake. Excuse me. I mean, it can reduce your oxygen intake, it can reduce, you know, your ability to breathe. It can actually be more harmful than good. We know that those are not true on their face. But what can you say to people who have seen these things, especially again on social media and are wondering, wait, am I going to have lower oxygen amounts in my bloodstream? Am I going to actually do some harm to my body by wearing a mask at the same time that I’m trying to protect others?


Dr. Jessica Ericson – So the first thing I would like to draw people’s attention to is surgeons who are wearing these masks occupationally, you know, for days on end, for hours on end. You know, there are occasionally surgeries that lasts 30, 40 hours, and your surgeon is wearing a mask that whole time, and they are not getting low oxygen to their brain that’s making them do your surgery less well. So I think that’s an excellent piece of evidence that these masks do not restrict airflow in a person who has even close to normal lungs. The only caveat to that is someone who is just barely getting enough oxygen [inaudible]. Someone who needs oxygen all the time, who has emphysema, some breathing problems that’s so severe that even an immeasurable amount of restriction with a mask could make it more difficult for them to breathe. Those people should not wear a mask. For anyone who is even close to normal, they do not restrict your oxygen level. You’re still doing a good job after wearing one for years is clear evidence of that.


Scott Gilbert – Sounds good. We have a question now from Steph. She was asking about this mask like I held up earlier here. How many times can you wear one of these surgical masks like this, like the one that I had on? Or how long should you use it before discarding it? Because it’s true, they are disposable.


Dr. Jessica Ericson – That’s right. So in general, those are single use masks. So you can’t wash them. So it would be best to wear those for one outing on one occasion, and then to throw them away. If you use them for several days on end, then the material can actually start to degrade where they’re going to be less protective. For instance, if you’re keeping it in your car where it’s hot or handling it quite a lot. But you could probably wear it, you know, for a week or so, and they’re going to be doing some good for you. So if it’s one of those things where there’s the best case scenario, which would be to use it one time and throw it away. And, you know, what’s kind of practical, which is to use it very carefully where you’re only handling the strings so that you’re not contaminating your hands and the mask every time you take it on and off. In that case, you could use it reasonably for, you know, a few days.


Scott Gilbert – All right. Yeah, you’re watching Ask Us Anything About Wearing a Mask from Penn State Health. We’re getting some great advice today from Dr. Jessica Erickson. She’s an epidemiologist, also an infectious disease specialist at Penn State Health Children’s Hospital. So we welcome you to add your questions to the comment field as we kind of wrap things up here. Because we have been on for a while providing some great information, and I appreciate Dr. Erickson’s time here today. One thing I had a question about was accessibility issues with regard to a mask like this. When someone has the mask on, you can’t see what they [inaudible]. You can’t read their lips and for some people, it’s very Important that they’re able to read lips, because they may be hearing impaired. Have you seen the window masks and, you know, perhaps that that’s a good solution that people have that concern maybe?


Dr. Jessica Ericson – I haven’t seen those. But that’s an exciting innovation. Because you’re absolutely right that all these things, you know, when we try to do something make the lives of everyone better. Sometimes that has unintended consequences, like, causing problems for people who use the [inaudible] to communicate. So I haven’t seen those, but I’d be excited to learn more about them.


Scott Gilbert – Yeah, well, thank you very much, Dr. Erickson. It’s been great talking with you. We’ll let you get back to work, and we appreciate your time today. We also appreciate everybody else’s time and questions. If you have additional questions, even if you’re watching this on playback, feel free to add those to the comment field, [inaudible] Facebook posts. And we can still pose those to Dr. Erickson and get you some answers written as a response. Thank you, Dr. Erickson, and thank you very much for watching. Ask Us Anything About Wearing a Mask from Penn State Health.

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