Should I Still Wear A Mask?

Three years on, living with COVID-19 seems to be our new reality. Even with the advent of safety guidelines and vaccines, the virus continues to mutate and spread, wreaking havoc in our communities. 

As of January 4, 2023, the US Centers for Disease Control and Prevention (CDC) reported 67,243 weekly new cases (a 16.2% increase over the previous 7-day average of 57,847). There was an 8.3% increase in deaths (390) compared with the previous 7-day average (360).  At the time of writing, over a million COVID-19 deaths total have been reported in the US.¹ ²

Perhaps even more concerning is that these numbers do not truly reflect the current number of people infected with the virus. Many people test at home and don’t report the results; many others never even take a test. As a result, experts believe that only around four to five percent of COVID-19 cases are reported.³

One of the easiest and most effective safety guidelines put in place at the start of the pandemic was wearing face masks to slow the spread of the virus. Masks protect both the wearer and others around them from being infected by the virus. 

However, near the end of September 2022, the CDC issued new guidelines indicating masks are no longer required to be worn by health workers in communities where COVID-19 transmission levels are low. The CDC also provides specific stipulations to guide mask-wearing in healthcare settings.⁴

The revised guidelines state that wearing a mask will still be required by healthcare professionals who work in areas where community transmission is high.  So, if there’s a suspected case of COVID-19, or a person works in a facility that has had a COVID-19 outbreak within the past 14 days, masks are still strongly recommended.⁴

Wearing a mask is, however, considered optional in areas where patient access is restricted (such as in staff meeting rooms). Healthcare professionals who have recently tested positive for COVID-19, or have recently come into contact with a person who tested positive, should wear a mask everywhere and minimize contact with others for 10 days. 

It’s important to note that these are simply guidelines. They certainly don’t prevent anyone from wearing masks if they desire to. Some experts also believe that we should still be maintaining mandatory mask-wearing policies, particularly in healthcare. 

This new guideline is intended for people working in healthcare settings in the US. For people outside of healthcare settings, mask-wearing is considered optional. The CDC does recommend that people at high risk consider wearing masks in public spaces when the rates of COVID-19 transmission in their community are medium or high. 

Masks are particularly recommended in settings like public transportation that may be crowded or have poor ventilation. You should also practice other protective measures, such as getting vaccinated and staying up to date with your boosters.⁵

Do face masks really work?

The effectiveness of face masks in preventing and slowing the spread of the virus has been debated since the first mask regulations were put in place. Given how quickly the virus spread and mutated, even when mask policies were in place, it’s understandable for people to question the usefulness of face masks. 

The first thing to understand is how exactly face masks work. Coronavirus spreads through respiratory droplets.

These droplets form when a person coughs, sneezes, or even speaks. In some cases, the droplets are so tiny that they’re  invisible. A face mask that adequately covers your nose and mouth contains these droplets and prevents the virus from spreading.

In a 2022 report by the CDC, researchers found that between February to December 2021, people who always wore a mask when they were in indoor spaces with others were significantly less likely to test positive for COVID-19. 

Wearing a cloth mask reduced the risk of infection by 56%, while wearing a surgical mask reduced it by 66%, and wearing an N95 or KN95 respirator-style mask reduced it by 83%.⁶

Some variants, such as Omicron’s newest variant, XBB.1.5, are more transmissible than older variants — cloth masks may offer less protection against them. 

Cloth masks are not very effective at filtering out particles because most of the fibers have been twisted into threads, leaving gaps between the threads that are not well-covered. 

However, wearing a cloth mask remains safer than wearing no mask.  Using two to four layers of fabric to make a cloth mask can increase its effectiveness. Non-woven masks such as surgical masks, N95, or KN95 respirator-style masks perform better than fabric masks.⁷

Medical-grade surgical masks also offer better protection than cloth masks. The downside with surgical masks is that they are single-use, which means they are only meant to be worn once. Some people also report finding surgical masks uncomfortable, especially for long periods. 

When wearing a surgical mask, it’s crucial to opt for one with a brace (bendable metal nosepiece) you can pinch for a better fit.

The most effective masks you can wear are the N95 and KN95 masks. These masks meet specific technical standards that render them particularly effective in protecting against the virus. They can also be worn multiple times.⁸

According to the CDC, these masks provide the highest protection against the virus. Although they are reusable, you should change your N95 or KN95 mask as soon as it becomes visibly damaged or dirty. You can also check the manufacturer’s guidelines. Unlike cloth masks, these masks can’t be washed, as this will damage them.⁹

Wearing a mask remains an effective way to protect yourself from getting COVID-19 and prevent yourself from spreading the virus. If you’re at high risk for having severe disease from the COVID-19 virus, or if you live with someone who is, then you should consider continuing to mask when you’re out in public in an indoor space, particularly when there’s a medium to a high level of community transmission.

How to use a face mask properly

If you do choose to use a mask, it’s important to use it properly. This makes a big difference in how effective it is. A mask should be well-fitted around your face. This means that it fits properly across the contours of your face, preventing any leakage from around its edges. Your mask must fit snugly around your mouth, nose, and chin. 

One way to test if your mask is fitted properly is simply breathing in and out. If you feel air coming out of the sides, top, or bottom of your mask, or your glasses are fogging up, your mask is leaking. Remember, you want air to go through your mask, not around it.

Masks with multiple layers offer more protection than single-layer masks, particularly cloth masks. You could also consider using a different type of mask. N95 and KN95 masks don’t need to be used with extra layers.

Other tips to consider when wearing masks to ensure you are getting the best protection out of it include:¹⁰

• Washing or sanitizing your hands before you put on the mask and immediately after you take it off

• Not touching your mask while wearing it

• Disposing of single-use masks as soon as you take them off

• Washing cloth masks regularly and drying them in the sun or the dryer 

• Switching to a clean mask as soon as your mask becomes dirty or wet 

• Removing your masks using the ear loops and avoiding touching the front of the mask while removing it

• Put wet or dirty cloth masks in a sealed bag if you are unable to wash them immediately 

When should I wear a face mask?

According to the CDC, if you live in a community where transmission is low, you don’t necessarily need a mask, although you may choose to wear one when you want. The guidelines also strongly recommend that everyone use a mask while using public transportation (such as an airplane, bus, or train), even though this is no longer an enforceable public health order.

For communities at a medium level of transmission, the CDC recommends wearing a mask when interacting with people at high risk of developing severe complications if infected with COVID-19. They also suggest getting tested for the virus before spending extended time with people in this category. 

People who live in communities with high transmission levels should always wear a high-quality mask. If you are immunocompromised or have a condition that makes you especially vulnerable to the virus, you should also avoid non-essential indoor activities and spaces where you are at a higher risk of contracting the virus. You can learn whether community levels in your part of the US are high, medium, or low, using the CDC’s COVID-19 Community Level tool.¹⁰ ¹¹

Should I still wear a face mask even though I’ve been vaccinated?

CDC guidelines no longer recommend that most people wear face masks when out in public, except when they’re on public transportation or in areas where community transmission has increased. Even in healthcare settings, the newest CDC guidelines no longer recommend universal mask-wearing, although it’s still recommended in higher-risk situations.

Of course, these guidelines certainly don’t mean people can’t continue wearing masks if they feel more comfortable doing so. Some people may prefer to continue wearing masks anyway, and this decision should be respected. Wearing a face mask is meant to not only protect you from the virus but to protect others and slow the spread. Here are five reasons that people may choose to continue masking. 

The vaccine doesn’t protect you immediately 

It takes some time for the vaccine to kick in and provide optimal protection. The Moderna or Pfizer vaccine takes two weeks to become 95% effective. Single-dose vaccines take about the same time to achieve the same level of effectiveness. If you’ve just gotten vaccinated, you may want to keep masking for a while.¹²

Vaccines don’t provide 100% protection 

Vaccines remain our most potent weapon in the fight against coronavirus. Still, they don’t provide you with 100% protection, and those vaccinated can still get infected with COVID-19. It’s crucial to stay up to date with your booster shots. If you’re in a high-risk area or spend time with people at high risk for severe disease, you may want to continue to mask, even if you’re fully vaccinated.¹²

You can protect others 

There are people with compromised immune systems and those who can’t be vaccinated who benefit from others in the community wearing masks to reduce transmission. Masks have contributed greatly to slowing the spread of the virus. Research also shows that the efficacy of the vaccine reduces with time. This means you may want to wear a mask if it’s been a while since your last booster.¹³

You can still spread the virus with no symptoms 

Being vaccinated doesn’t completely prevent you from contracting and spreading the virus. Some people have no symptoms of COVID-19 (also known as being asymptomatic), making it particularly easy to spread the virus. If you wear a mask, you reduce worry that you may inadvertently be spreading the virus.

The lowdown 

The latest CDC guidelines no longer recommend universal masking, either for the general public or for healthcare professionals. In higher-risk situations, masking is still recommended. These include when you’re on public transportation, in a community with a higher level of transmission, or if you’re medically at high risk for severe disease or live with someone who is. It’s important to recognize that the COVID-19 pandemic is not over; the virus continues to spread and mutate, and people continue to die from COVID-19. You may choose to continue wearing a mask to help protect yourself and others, and this decision should be respected.

References:

1. Covid data tracker weekly review | Centers for Disease Control and Prevention

2. United States | Johns Hopkins Coronavirus Resources Center

3. Covid testing providers scale back despite worries of another winter surge | NBC News

4. Interim infection prevention and control recommendations for healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic | Centers for Disease Control and Prevention

5. Use and care of masks | Centers for Disease Control and Prevention

6. Effectiveness of face mask or respirator use in indoor public settings for prevention of SARS-CoV-2 infection — California, february–december 2021 | Centers for Disease Control and Prevention

7. How do masks work? | Science Exchange

8. Why you should upgrade your mask to an N95? | Intelligencer

9. How many times can you wear an N95 face mask? | AARP

10. Use and care of masks | Centers for Disease Control and Prevention

11. COVID-19 by county | Centers for Disease Control and Prevention

12. Vaccine efficacy, effectiveness and protection | World Health Organization

13. Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: Results of a systematic review and meta-regression (2022)

Toketemu Ohwovoriole is a healthcare writer who has spent the last six years creating content for companies and publications around the globe. She has been featured in The Huffington Post, Insider, Verywell, and other major publications. Her previous work delves into the mental and physical health effects of birth control, overall wellness, and sensitive women's healthcare issues.