Masks

Carrie Pyfer, of Lancaster city, wears a surgical mask while carrying her daughter in Lancaster Central Market on Tuesday, Nov. 17, 2020.

THE ISSUE

Executive orders issued by President Joe Biden now require that masks be worn by federal employees and contractors and by “other individuals in Federal buildings and on Federal lands,” and in airports, commercial aircraft, trains, ferries, intercity bus services and other forms of public transportation. “Science-based public health measures are critical to preventing the spread of coronavirus disease 2019,” the executive order regarding public transportation states. Biden has asked Americans to do our “patriotic” duty by masking up for at least the first 100 days of his administration.

We begin with a thank-you to essential workers who will be on the job today, despite the weather — caring for the sick, staffing grocery stores, responding to emergencies, reporting the news, plowing and salting the roads, and ensuring that public utilities continue to function.

A meaningful way for us to thank them would be to wear masks without complaint when we leave our homes and are in the presence of essential workers, to help them remain healthy.

That isn’t just good manners — mask-wearing in public is a mandate in Pennsylvania.

What is not required, but might be a good idea, is doubling up on our face masks.

We raise this subject with some wariness, as we know some Americans continue to object to wearing masks at all. That’s a stance we’ve never understood, and continue to lament, because being asked to wear a mask for the sake of public health — and for our own — is such a minor request. Especially when mask-wearing is such a simple and effective way to help limit the spread of COVID-19.

So we appreciate anyone who wears a mask consistently and without grumbling. And we ask that you just consider this editorial in the spirit in which it’s offered — as a suggestion that might help to keep you safer.

President Biden and Vice President Kamala Harris have appeared in public on multiple occasions wearing two masks each. Same goes for Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and the Biden administration’s chief medical adviser.

“If you have a physical covering with one layer, you put another layer on, it just makes common sense that it likely would be more effective,” Fauci said on NBC’s “Today” show last week. “And that’s the reason why you see people either double-masking or doing a version of an N95.”

To be clear, doubling up on masks is not yet the recommendation of the Centers for Disease Control and Prevention. But the CDC does recommend masks that have “two or more layers of washable, breathable fabric,” completely cover your nose and mouth, and fit “snugly against the sides of your face.”

Likewise, the Johns Hopkins Medicine website recommends that a mask “conforms to your face without gaps — it is important that most of the air you breathe in and out flows through the mask rather than around the mask through gaps at the sides, top or bottom.” It also recommends that your mask be made from “several layers of tightly woven fabric in order to be an effective filter,” and that it has “a flexible nose bridge to conform to the face and prevent fogging of eyeglasses.”

The problem with some nonmedical face coverings is that they are sometimes flimsy.

The CDC says neck gaiters — those tube-like face coverings — can be protective if folded into layers, but Johns Hopkins, a leading coronavirus researcher, doesn’t permit the wearing of gaiters or bandannas in its facilities.

A bandanna is better than nothing, but it doesn’t provide much protection because it doesn’t fit all that snugly and can be lifted by a stiff breeze.

N95 masks are the most protective, but they remain in short supply, and so health experts recommend they be reserved for health care providers.

So double-masking may be the answer. Or wearing masks that have pockets for filters. Or wearing multilayered masks.

A commentary published last month in the medical journal Cell — penned by Monica Gandhi, an infectious disease physician at the University of California at San Francisco, and Linsey Marr, an engineering professor at Virginia Tech — examined the effectiveness of mask-wearing.

When Kansas counties maintained “mask mandates unevenly during the summer surge,” Gandhi and Marr noted, “COVID-19 incidence decreased in the counties with mask mandates, but continued to increase in those without.”

Research shows that by “reducing inhalation of viral particles by the mask wearer,” they wrote, “masks can protect the individual from COVID-19 acquisition,” or, “if acquired, possibly lead to a milder or asymptomatic infection.”

When a person wears a mask, they explained, “air must curve as it flows around individual, tightly packed fibers of the material, like a race car swerving around cones of an obstacle course.” Aerosols conveyed by air “cannot make the sharp bends and therefore slam into the fibers, or they come too close to the fibers and stick to them.”

Their recommendation is to wear a high-quality surgical mask — those often-blue masks that consist of three layers of nonwoven material — or a fabric mask with at least “two layers with high thread count for basic protection.”

For “maximal protection,” Gandhi and Marr wrote, members of the public can either wear “a cloth mask tightly on top of a surgical mask where the surgical mask acts as a filter and the cloth mask provides an additional layer of filtration while improving the fit.” Or we can wear a three-layer mask “with outer layers consisting of a flexible, tightly woven fabric that can conform well to the face and a middle layer consisting of a nonwoven high-efficiency filter material (e.g., vacuum bag material).”

We’ll need to wear masks for the foreseeable future while we await our turn to be vaccinated against COVID-19, and even afterward, because it’s not yet known if vaccinated individuals still can spread the virus.

As even more contagious variants of the novel coronavirus circulate in the United States, we want you to be safe. And to help others to remain safe.

To combat those variants, Germany has tightened the rules on what masks may be worn in public, and France now recommends against homemade fabric masks.

Until the U.S. can significantly ramp up production of better masks — like N95 masks — many of us will rely on fabric masks. So let’s consider doubling up.

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