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Updated: Surgeon Explains CDC Public Mask Guidelines for COVID-19

The Centers for Disease Control and Prevention (CDC) is encouraging all Americans - even people who feel perfectly healthy - to wear cloth face coverings in public, where it is most difficult to maintain 6-feet social distancing, in an effort to help slow the spread of the coronavirus.

The new guidance, announced at the end of April, was a reversal from previous CDC recommendations that face masks needed to be worn only by people who were sick with COVID-19 or by those caring for someone with symptoms.

VIDEO: Dr. Calendine Discusses Cloth Face Covering Guidelines and Recommendations

So why were face masks discouraged at the beginning of the COVID-19 pandemic?

Initially, experts didn't know the extent to which people with COVID-19 could spread the virus before any symptoms appeared. We now better understand that some people can carry and spread COVID-19 and have no symptoms of illness. Both asymptomatic and pre-symptomatic patients can unknowingly spread the virus to others.

These discoveries have led the U.S. Centers for Disease Control and Prevention (CDC) to update face covering guidelines. Updated CDC guidelines recommend widespread use of simple cloth face coverings to help prevent transmission of COVID-19 by all people (over the age of 2 yo) in public settings, especially when other social distancing measures are difficult to maintain.

Of note, the CDC recommends cloth masks be used by the general public while reserving surgical and N95 masks for use by health care providers.

RELATED BLOG ARTICLE: Should Kids Wear Face Masks? Suggestions from a Physician Dad

How do the different types of masks work?

Cloth masks

Cloth masks do not provide the same level of protection as the medical-grade masks discussed below, but if worn correctly, they can block some larger droplets from coughs and sneezes. A cloth mask is worn mainly to help protect others in case the wearer has the virus. Wearing a cloth mask does not change the importance of social distancing. You should still make every effort to stay at least 6 feet away from other people when you go out in public. A cloth mask may help to prevent you from giving the virus to others, but it provides very little protection for you (the wearer). Therefore, it is still important that you stay home as much as possible and continue to properly wash your hands.

Surgical masks

A surgical mask is a loose-fitting disposable medical mask that protects the wearer's nose and mouth from contact with droplets, splashes and sprays that may contain germs. A surgical mask can also filter out larger particles in the air. Surgical masks may protect others by reducing exposure to the saliva and respiratory secretions of the mask wearer.

A surgical mask does not filter or block very small particles in the air that may be transmitted by coughs, sneezes, or during medical procedures. Surgical masks also provide only limited protection from germs and other contaminants because of the loose fit between the surface of the face mask and the face.

At this time, the U.S. Food and Drug Administration has not approved any type of surgical mask specifically for protection against the COVID-19 virus, but these masks may provide some protection in healthcare settings when N95 masks are not available.

Surgical masks (pictured above) and N95 masks (discussed below) should be reserved for healthcare workers.

N95 masks

N95 masks offer more protection than a surgical mask does because it can filter out much smaller airborne particles. The name indicates that the mask is a filtering respirator designed to block 95% of very small particles (N95 classification of air filtration set by U.S. National Institute for Occupational Safety and Health(NIOSH)).

Like surgical masks, N95 masks are intended to be disposable but can be reused with proper disinfecting. Originally designed for industrial use, N95 masks became a healthcare standard subsequent to virus-blocking technology invented by University of Tennessee professor Peter Tsai and was patented in 1995. Recently, Dr. Tsai came out of retirement to research N95 mask decontamination and help alleviate shortages during the current coronavirus pandemic.

How to Wear a Cloth Face Covering : Tips anD Tricks

According to the CDC, cloth face coverings should—

  • fit snugly but comfortably against the side of the face
  • be secured with ties or ear loops
  • include multiple layers of fabric
  • allow for breathing without restriction
  • be able to be laundered and machine dried without damage or change to shape
Cloth face coverings can be made inexpensively with materials you have at home (see Instruction links below)

Additional tips for making the most of your cloth facial covering include:

  • Wash your hands with soap and water before putting on the mask. If you do not have soap and water available, used an alcohol-based hand rub.
  • Cover your mouth and nose with the mask. Make sure it is snug to your face.
  • Do not touch the mask while using it. Do not touch any other areas of your face.
  • As soon as you return home, take the mask off and put it in the wash.
  • Remove the mask by touching it from behind. Do not touch the front of the mask. Throw it in the washing machine and wash your hands immediately.
"Wearing a cloth mask PROPERLY is as important as wearing a mask at all. It is harder than you think and takes a little practice." - Cory Calendine, MD

Cloth Face Covering Precautions:

Cloth Face Mask Recources:

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Cory Calendine, MD is an Orthopaedic Surgeon and founding partner of the Bone and Joint Institute of Tennessee at Williamson County Hospital in Franklin, TN. Dr. Calendine is an expert in Joint Replacement, specializing in Hip and Knee Surgery. From diagnosis through treatment, the Orthopaedic Surgical experts at the Bone and Joint Institute use the latest techniques and technology to improve care for people with musculoskeletal problems. For more information, please contact our office or schedule your appointment today.  

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