Are health officials now asking us to double mask? A local expert shares her recommendation

It’s all masks all the time at our new office on Morris Avenue. Photo via Matthew Niblett for Bham Now

At President Joe Biden’s inauguration, we saw a lot of firsts, including a possible up and coming strategy to fight COVID-19—two masks.

Amanda Gorman, former President Obama and other politicians sported a double layer of masks on January 20. We’ve also seen football coaches multiply masks and call plays between two layers during games. Should we follow their lead?

In light of the new COVID-19 variants, we asked Rachael Lee, M.D., an Assistant Professor in the Division of Infectious Diseases at the University of Alabama Birmingham and Health Care Epiemeiologist for more information on the topic.

After nearly a year in the pandemic, why is double masking becoming a topic?

UAB Medicine
The first and most important step is wearing a mask. It protects you, those you love and eases the strain on frontline healthcare workers. Photo via UAB Medicine’s Facebook

“The discussion about double masking and the renewed interest in double masking has come about because there was a recent small study that showed more masking or double masking and increasing the layers of protection showed higher efficiency in protecting the individual.”

Rachael Lee, M.D., Assistant Professor in the Division of Infectious Diseases Health Care Epidemiologist, University of Alabama Birmingham
  1. UK Variant: Public health officials believe this strain to be more transmissible from one person to the next. However, this doesn’t mean it’s more airborne. “There’s a thought that you may have a higher amount of virus in your nose in this UK variant compared to others.”-Dr. Lee
  2. South African Variant: The reason that this variant is concerning to the CDC is it appears that some of our monoclonal antibodies may not help with treating that variant. *Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses.
  3. Brazil Variant: This variant has only been identified in a small number of people. According to Dr. Lee, it may have escaped our antibodies completely so while concerning, this variant has not been identified in the U.S.

The variants impact on masking

“From a masking perspective, with all of these variants, none of them are more airborne or are going to linger in the air for a long period of time compared to what we know.

The biggest thing here is that viruses make mutations when they replicate, so the more that we avoid crowds, wear our mask and stay six feet apart, they can’t jump from one person to the next. That’s really what we want to focus on.”

Dr. Lee

How effective is double masking?

woman in black t-shirt standing near brown wooden shelf
Following mask guidelines, especially indoors and in areas that are not well ventilated is vital for preventing COVID-19. Photo via Unsplash

The cause

If your indoors or in a situation where transmission rates of COVID-19 and its variants are high, a double mask could provide extra protection. Wearing a cloth mask over a surgical mask, or a singular mask that’s double-layered and has a filter in between is another option that creates a similar effect as wearing two masks, according to this expert at Boston University.

The consideration

If you decide to double mask, it’s important to be sure they don’t slip from one another. This can cause masks to move away from the mouth and nose, defeating the entire purpose of wearing a mask.

“I think the first step is making sure everyone is wearing a mask before we even consider whether or not double masking will help or not.”

Dr. Lee

The other issue is wearing two masks may make it harder to breathe. So, you’re more likely to touch or move it which health officials don’t recommend.

The conclusion

“From a clinical standpoint and from a public health standpoint, what really matters is making sure that you are wearing a well-fitted mask. That means a mask that fully covers your nose and your mouth, has at least two layers and that is tightly woven if you’re wearing a cloth mask.”

Dr. Lee

Best mask practices

stack of white yellow green and blue textiles
Consider opting for cloth masks with two layers of fabric and a filter in-between. Photo via Unsplash

Like Dr. Lee said, as per CDC guidelines, you should choose a mask with two layers that fits comfortably over your face and fully covers your nose and mouth.

“My recommendation and what I practice is a single well-fitting mask. When I’m outside of the hospital, I do wear a cloth mask that is tightly woven and fits my face comfortably so when I talk it does not move or go out of place.”

Dr. Lee

Cloth, KF94 and N95

If you’re considering “upgrading” your mask as an effort to protect yourself from the new COVID-19 variants, it should follow Dr. Lee’s above recommendation. Incorporating the medical-grade N95 doesn’t necessarily guarantee heightened protection.

“The reason that health care workers wear N95 respirators is they are fitted to the person’s face and they protect us from infections that are airborne like measles or tuberculosis. There have been some cases in the healthcare setting where potentially COVID-19 may be spread through airborne generating features.”

Dr. Lee

For the general public, however, we’re not fit tested for those N95 like health care professionals are. So, Dr. Lee says she can’t ensure you’re getting the 100% coverage around your face you could get in a hospital.

You’ll run into the same deal with the KF94—the South Korean equivalent to an N94. However, you may find more luck finding a comfortable face mask in KF94 models. Comfort equals less fidgeting and therefore less room for contamination of your mask.

“I’ve heard the KN94 is more comfortable to wear for a prolonged period of time. So wear it, as long as you realize you’re not getting increased protection necessarily.”

Dr. Lee

Caring for your mask

Double mask or no, it’s also extremely imperative you’re properly cleaning your mask. Dr. Lee recommends you only rely on one mask per day.

As you’re breathing in and out of it, talking to people and removing it, the mask can quickly become contaminated. Stock up for seven days a week and keep all your favorites on rotation.

Also, be sure to use hand hygiene before taking it on or off to make sure the outside area stays clean and doesn’t contaminate yourself.

Beyond the mask

Dr. Lee reminds us that wearing a mask is only one part of the strategy in fighting COVID-19. Masks are just as important as physical distancing, staying home if you’re sick and washing your hands frequently.

Especially as we’re learning about these new variants and are unsure what to expect, we can never be too careful when it comes to COVID.

To sum it up: find a really great mask that’s well made, fits your face and you can wear comfortably for a long period of time. No matter what mask you decide to wear, consistent and earnest mask-wearing is always in-style.

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Irene Richardson
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