Science has shown that masks help to prevent the spread of COVID-19, but certain questions and theories about their safety and efficacy continue to circulate, which can make it hard to tell the difference between fact and fiction.
To set the record straight, we spoke with George Alba, MD, a researcher and pulmonary and critical care specialist at Massachusetts General Hospital. Here are a few things you may have heard about wearing (or not wearing) a mask as part of the general public.
In case you missed it, check out our first article featuring Dr. Alba about the differences between mask types.
A number of studies have examined the changes in SARS-CoV-2 infection rates after mask mandates were put in place. One study in Health Affairs found that mask mandates were associated with a daily decline in COVID-19 cases in fifteen states and the District of Colombia once implemented. Researchers estimate that approximately 200,000 cases were prevented during the first three weeks of those mask mandates.
Resource: The Difference Between N95s, Surgical Masks and Cloth Masks – Bench Press
Resource: Considerations for Wearing Masks – Center for Disease Control and Prevention (CDC)
MYTH #2
MYTH: You only need to wear a mask if you are sick.
FACT #2
FACT: Some individuals can carry and spread the COVID-19 without having symptoms.
Since anyone could carry the virus without knowing it, it is safer to always wear a mask.
Resource: Transmission of SARS-CoV-2: Implications for Infection Prevention Precautions – World Health Organization
MYTH #3
MYTH: You don’t need to wear a mask if you are maintaining physical distance of at least six feet from other people.
FACT #3
FACT: The CDC recommends that people wear masks in public settings and when around people who don’t live in your household, especially when physical distancing measures are difficult to maintain. Standing six feet apart, wearing a mask and handwashing are all preventative measures that, when combined, significantly reduce the risk of spreading the disease.
The CDC recommends wearing masks in all public settings.
MYTH #4
MYTH: Masks limit your oxygen intake and increase the buildup of carbon dioxide, which can be dangerous.
FACT #4
FACT: Masks have no effect on oxygen levels and can be worn safely for extended periods of time.
Surgical teams wear masks during operations in operating rooms for hours at a time without any adverse changes in oxygen or carbon dioxide levels. The symptoms that some people may experience when wearing a mask are more likely to be associated with anxiety than lack of oxygen, says Alba.
“There are folks who have underlying lung disease and chronic shortness of breath where wearing a mask can make it uncomfortable to breathe for prolonged periods of time. But I see many patients in the clinic with advanced lung disease who wear masks because they understand it is not only a benefit to themselves, but also to the people around them. They rely on everyone else wearing a mask to keep them safe.”
While most individuals can wear masks without any issues, masks should NOT be worn by children under the age of 2 or anyone who has trouble breathing, is unconscious, incapacitated, or otherwise unable to remove the mask without help, according to CDC guidelines.
Resource: Considerations for Wearing Masks – CDC
It’s important to remember that your nasal cavity and throat are connected via the nasopharynx. Because of this, your mouth and nose are both portals of entry and exit for viral particles.
“You want to make sure any communication with your nasopharynx is covered, because even if you cover one part of it you still have another part that is uncovered and capable of releasing or taking in particles,” says Alba.
Resource: How to Wear Masks – CDC
MYTH #6
MYTH: N95 respirators are the only masks that can effectively protect you from the virus.
FACT #6
FACT: The CDC recommends cloth masks for use in public.
The recommendation that the public wear cloth masks is specifically intended to prevent the spread of the infection in the community. In fact, universal masking is considered to be the most effective way to reduce the spread of the virus.
For example, in May, two hair stylists at a hair salon in Missouri contracted COVID-19 and developed respiratory symptoms. By the time they received their positive test results, they had served over 100 clients. The stylists were wearing cloth or surgical facemasks, and all clients wore face coverings during their visits. A team of researchers closely monitored the health of all 139 clients and none were reported to have been infected.
Resource: Considerations for Wearing Masks – CDC
Resource: The Difference Between N95s, Surgical Masks and Cloth Masks – Bench Press
Large crowds pose a greater risk than a gathering of a few people, but it only takes one infectious person to transmit the disease—sometimes to multiple people at one time. Since the virus can be transmitted by someone without any obvious symptoms, we have to assume that anyone could be infected at any time.
MYTH #8
MYTH: Homemade cloth masks don’t work.
FACT #8
FACT: Multilayer cloth masks, if worn and removed correctly, are a good option for the public to use in community settings.
Keep in mind that while cloth masks are reusable, they should be washed regularly. You should also know that not all cloth masks are created equal, so if you’re unsure about the mask you are wearing, use the CDC guidance to select a one with the right features.
Source: How to Select, Wear and Clean Your Mask – CDC
Resource: Considerations for Wearing Masks – CDC
Resource: How to Make Masks – CDC
MYTH #9
MYTH: The death rate from COVID-19 is low, so wearing a mask doesn’t matter either way.
FACT #9
FACT: COVID-19 is at least 5-10 times deadlier than influenza.
It is true that most people will survive a COVID-19 infection, but widespread disease means that large numbers of individuals will require hospitalization, which can strain the resources of healthcare systems and lead to complications or death.
It is also critical to note that surviving COVID-19 does not always mean a full recovery. “We are seeing a number of long-term symptoms associated with infection, especially people who were critically ill,” says Alba.
“There are a lot of patients who were hospitalized for prolonged periods of time and need rehabilitation, patients struggling with anxiety or post-traumatic stress disorder, and other long-term consequences that we are still learning about that we do not want to see on a more widespread level.”
MYTH #10
MYTH: You don’t need to wear a mask if you’re outside.
FACT #10
FACT: Outside in open air is lower risk than indoor activities, but it is not completely risk-free.
Being outdoors without a mask is safer than being indoors when it comes to risk for infection, but the risk increases whenever non-household members do not maintain physical distance regardless of the setting. If you’re planning to spend time outdoors, you should still carry a mask with you in case something unexpected occurs.
“You just don’t know when you will be in a situation where you will be unable to remain socially distant, so you should always have a mask with you.”
While we were all hoping the pandemic would be short-lived, it is now clear that this will be a marathon, not a sprint. There is evidence that shows masks work, both in Massachusetts and around the globe, so in the interest of keeping ourselves, our family and friends, and our community safe—we should be prepared to wear masks for the foreseeable future.
“We should be guided by a common desire to care about other people, especially the most vulnerable among us,” says Alba. “It’s important to have the best interest of our fellow citizens and health care workers on the front lines in mind. We need to be thinking about how we can get through this together, not in factions.”
COVID-19 Research at Mass General
Researchers and clinicians at Massachusetts General Hospital Research Institute are mobilizing to develop new strategies to diagnose, treat and prevent COVID-19. Learn more.
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