Eleven Covid19 Mask Questions- Answered!!

Answers here are by Karen H. Calhoun MD (kcalhoun98@gmail.com), a retired surgeon who is very familiar with mask-wearing and how infections spread.

I am 30 years old and healthy- and I’m not afraid of covid19.  Why should I wear a mask?


I don’t mind wearing a mask if I’m feeling under the weather, but why should I bother when I’m feeling perfectly well?

Young man in a hoodie wearing a black mask

*Covid19 is a tricky virus.  You can feel perfectly well, and still be breathing out lots of viral particles that can infect others.  A high percentage of people (20-50%, we think) can have a Covid19 infection and never have any symptoms.  There’s no way for them to tell if they are infected or not (unless they have a blood test- and why would they when they’re feeling well?).  
*Even worse, the people who do get sick shed virus (breath out viral particles that can infect someone else) for 4-5 days before they develop any signs of being sick.  
*The bottom line is that how well you feel doesn’t tell if you are going to be infecting others or not.  So be polite, wear a mask around others not in your household.  

Why is it mostly old or frail people who die from Covid19- and then I read stories about a perfectly healthy person in their 20’s, 30’s and 40’s who die of it?

We don’t know.  So far, nobody has identified a risk factor that tells us which of these healthy people are likely to get sick or die from Covid19.  That is part of its trickiness, and what makes it so scary!

Who am I wearing a mask for?  To protect me from others, or to protect others from me?

Both.   Above you heard how people can spread infection even when they are feeling perfectly well.  A mask can prevent this.   A mask that fits well also filters the air you are breathing in.  Since we think that the more virus you are exposed to, the sicker you can get- filtering out even some of the virus around you is helpful.   

My dad wears his mask pulled under his nose.  Is that OK?

If he never breathes in or out through his nose, maybe.  If he breathes half through his nose and half through his mouth, it’s half effective.  Is his mask uncomfortable?  Perhaps a different type of tie or size of mask would be more comfortable for him and let him cover both his nose and his mouth?

When I’m running, I leave the mask around my neck and just pull it up to cover my mouth and nose when I see that I’m going to pass another person.  Is this OK?

The danger with repeatedly touching your mask to put it up and down is that you are touching your face.  Since you’re not touching other potentially-contaminated surfaces while running, this is a reasonable compromise.  Still, keep a 10 - 20 foot distance from others.  Someone running hard and breathing hard could be breathing out viral particles substantially farther than 6 feet.  And avoid running in their wake-  the exact direction they just came from, as viral particles could linger in the air for a few minutes.  

I have asthma, and when I put a mask on I get claustrophobic feeling like I can’t breathe, and that can bring on a panic attack.  What should I do?

That’s really tough.  Panic attacks are really nasty.  Here are some ideas to consider:
*Try a number of different mask designs.  You may find that a particular type is more comfortable for you.
*You might try wearing a mask around your home some of the time.  It’s a safe environment, and you might get used to mask-wearing.
*Rely on self-isolating, except for your household members.  
*In a work situation, consider explaining your dilemma, and asking others to be generous with wearing masks around you.

What is the correct way to take a mask off? 

Assume the front of the mask is contaminated, from filtering the air you are breathing in.   First, wash your hands.  Take the mask off using just the ties and (best practice) toss it right in the washing machine.  Then wash your hands again!  If you can’t wash it immediately, put it somewhere dry to rest until your next wearing.  

What is the best kind of mask to wear?

*Any kind of mask is better than none.
*N-95 or N-99 masks or respirators are the best, but we currently need to reserve these for medical personnel dealing with multiple Covid19 patients.
*A mask with two layers of closely woven cotton outperforms single layer masks.
*Knit fabrics such as socks or T-shirts don’t filter as well as woven cotton fabric
*A pocket in the mask to insert an additional filter (coffee filter, HEPA vacuum cleaner bag, etc) is helpful.
*A wire over the bridge of the nose is helpful for adjusting fit. 

My glasses fog up when I put a mask on.  Is there a way to handle this?

Fogging up means that the warm air you just breathed out is exiting the mask under the eyes and across the nose.  Try a mask with a wire for fit adjustment over the nose and cheek area.  People have also had some success blocking this airflow with tissues or other soft material.  If air is going out this way, it is also coming in this way, unfiltered, so your mask is not protecting you as well as it could. 

What does it mean when someone refuses to wear a mask?  

Not wearing a mask around others not in your household is pretty much saying:
“My comfort in being mask-free is much more important to me than your health”.  Exceptions, of course, for those with breathing-related medical problems, who should be mostly self-isolating.

Take good care of yourself and stay well!!

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