These days, to venture outside in Seattle sans mask is to invite a discomfort akin to when you enter a theme party in blue jeans and a flannel. Around one bend, you’ll find someone using a hastily crafted quilt-and-vacuum-bag apparatus to cover up. Around another, you’ll see an honest-to-goodness gas mask. Everywhere, you’ll encounter recycled festival and hiking garb (bandanas, buffs). And, on occasion, you’ll observe a faux pas—a rain jacket collar that isn't quite tall enough, an N95 respirator on anyone other than a medical worker.
Since the CDC announced in early April that the public should start fashioning cloth face coverings to help halt the spread of the novel coronavirus, Seattle has embarked on a peculiar new normal when it comes to facial wear, one that might not necessarily end even if our current stay-at-home order expires on May 4. The CDC now advises people to don masks with multiple layers of fabric in places where our social distancing edict—six feet apart, everyone—remains difficult to follow, such as grocery stores or other highly trafficked indoor spaces. Though some have found their protective goods via local and online retailers, many others have opted to repurpose household items, a la U.S. surgeon general Jerome Adams. In an infomercial-esque demonstration on the CDC's website, Adams takes an old T-shirt and, with a couple folds and rubber bands, finishes a mask in less than a minute.
You could be forgiven for being confused. In late February, Adams urged the public not to buy masks because he claimed they weren’t effective in stopping the virus’s transmission. He's since walked back that position, but due in no small part to President Donald Trump's refusal to wear one, skeptics persist. Do face coverings actually help us?
The answer is definitively yes, according to Dr. Paul Pottinger, the director of the Infectious Diseases and Tropical Medicine Clinic at UW Medical Center. “The first and the most important thing that they do is to reduce the risk of us spreading an infection to other people. They keep our respiratory droplets from getting away,” Pottinger says. The droplets can come from the nose when we sneeze or the mouth when we cough, sing, or shout. And they can be contagious even if we don't feel sick. New research has shown what many in the medical community have long assumed: that asymptomatic and pre-symptomatic virus carriers can spread the disease to others, information that helped reverse the federal government’s stance on mass mask adoption.
Before you ascribe too much selflessness to the bandit bro set, know that a mask does benefit the person behind it. “If someone sneezes or coughs on our face, then of course those droplets can get into our nose or our mouth,” Pottinger says. “That’s how they make their way into the respiratory tract, and that’s what sets up an infection of COVID-19.”
Choosing a mask responsibly amid the coronavirus crisis entails avoiding the safest and most traditional route. N95 and surgical masks are the most effective types of facial coverings but should be reserved solely for healthcare professionals. Private hoarding of N95s contributed to personal protective equipment (PPE) shortages at hospitals early on in the crisis and, to some degree, the government’s mixed messaging about masks. Many of our local medical institutions have access to a robust supply chain now, but a great need for PPEs lingers, and it's in your own interest for it to be filled: Keeping our nurses and doctors healthy can have an exponential effect on flattening the curve. “Our hope is that people who may currently be using surgical masks or N95s will move to cloth masks instead and save the masks and respirators for our workers on the frontline,” says Sally Watkins, the executive director of the Washington State Nurses Association.
Many have heeded that advice and embraced DIY designs. For these projects, the CDC recommends using cotton fabric, which is not as impermeable as medical-grade offerings but is far better than nothing. Pottinger agrees, noting cotton's breathability. “It’s also less sticky for the virus than some other synthetic materials,” he says.
Though research is lacking in this area, your cotton's thickness probably matters. Experts recommend multiple folds and tight weaves; if you can see through your mask when holding it up to a light, it’s probably not sufficiently dense. Common sense should prevail, according to Swedish's Dr. Elizabeth Meade. She mentioned a kitchen towel as a quality material.
It’s also vital for the mask to be snug—secured from the bridge of your nose down to below your chin—and comfortable. “Some of the early data actually showed that when people are wearing the masks, they tend to touch their face more,” Meade says. “So, I think that if people are wearing masks, it's really important to continue to be cognizant about not touching our face, in particular our eyes, nose, and mouth.”
After detaching a mask, your work isn't done. You need to wash it. “The outer surface of that mask may be covered with respiratory droplets from other people. That’s a possibility. No big deal. No problem,” Pottinger says. “Take off that covering, throw it into the wash—and yes, any standard laundry cycle should kill off the virus. It’s very easy to kill. But people need to wash their hands after they get that mask off.”
A common mistake is to grab the contaminated front of your face covering instead of its loops or ties, so while Pottinger says “there’s really no need” to sport a mask outside if you’re following social distancing rules, it may well be easier to just keep it on as you go from place to place. Regardless of whether you're wearing your grandma's quilted creation or a sliced blend of old T-shirts, you can be sure that proper hygiene won't be going out of style anytime soon.