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While some people are still resisting the use of a face mask in public, despite strong evidence that covering the nose and mouth helps protect the user and people around them from COVID-19 infection, others are taking their level of protection a step further by doubling and using two.
Layered masks have been seen on everyone from President-elect Joe Biden to the New England Patriots coach Bill Belichick to essential public transport and supermarket workers.
But is wearing two masks really more effective than wearing one? And is it really safe in layers? We asked experts to evaluate.
Does wearing two face masks protect more against COVID-19 than one?
First, there is a lot of science to support the use of a face mask. Research shared by the Centers for Disease Control and Prevention (CDC) suggests that wearing masks can drastically reduce the spread of COVID-19 and, subsequently, hospitalizations and deaths from the new coronavirus.
For example, a frequently cited study of two hairdressers who had COVID-19 found that none of the 67 clients with whom they worked for an eight-day period who consented to the test developed an infection. The designers and their customers wore masks at the time of interaction. Another study of health care professionals in Boston found that there was a significant drop in positive coronavirus test results after the mask was adopted by the team.
“The goal of wearing a mask is to create a barrier,” says infectious disease specialist Amesh A. Adalja, MD, a senior fellow at the Johns Hopkins Center for Health Safety. “If you are wearing some kind of fragile mask, a mask double can help. ” But he adds that “it is not something that everyone needs to do”.
There is no hard data on the additional benefits of double masking yet, but experts have some theories about when it is worth considering, especially if you are using a non-medical facial cover (as most of us do).
“The double mask adds an extra layer of filter, making it even more difficult for drops of moisture loaded with the virus to reach you or spread to other people,” says Aline M. Holmes, DNP, RN, clinical associate professor at Rutgers University School of Nursing. She says this could serve as additional protection for people who are in high-risk environments for coronavirus transmission, such as a hospital or nursing home.
It may also be a good idea to fold if you are sick with COVID-19 and want to do everything you can to protect others in your home from being infected with the virus. (Note: you should still be isolated from other people whenever possible.)
However, many experts “don’t think it’s necessary,” including William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “I am happy that there are some people doubly committed to wearing a mask, but it has not been studied,” he says. “Double masking can provide some additional protection in both directions – both outside and inside – but it is not officially recommended by anyone at this point.”
It is worth noting: some doctors put on face masks as a way to help protect their valuable N95 respirators.
“When I walk into a COVID patient’s room, I use two – an N95 respirator with a surgical over it,” says Richard Watkins, MD, an infectious physician and professor of internal medicine at Northeast Ohio Medical University. “When I go out, I throw out the surgical one and keep the N95.” The goal, says Dr. Watkins, is to help protect your N95 mask for future use, as supplies are limited.
New England Patriots coach Bill Belichick, in the photo above, and elected vice president Kamala Harris in the photo below, were seen using this technique, for example. They have medical-grade masks under a cloth cover or surgical mask, probably to preserve the respirator for future use.
Is it safe to use two masks?
If you choose to use two face masks, “it won’t hurt you”, as long as you can still breathe easily, says Dr. Adalja. If you feel restricted, you will still have a layer of protection when you join a mask.
There also doesn’t seem to be a “right” way to do this or any specific type of mask that fits this method better. “Just make sure that the first mask fits your nose and mouth well,” says Dr. Schaffner.
In addition, it is important to remember that wearing two masks does not mean that you should stop distancing yourself socially from people outside your home and wash your hands frequently. “If you are folding your mask and are still engaging in risky behavior, it will not help you,” says Dr. Adalja.
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