Should We All Be Wearing Better Masks to Protect Against COVID-19 Variants?

We’ve come to accept cloth face masks as part of life during the COVID-19 pandemic. But now that researchers have identified a few coronavirus variants that appear to spread even more easily than the original, is it time for us to swap our cloth masks for more effective ones?

Germany, Austria, and France are all considering national recommendations to do just that, and just as President Biden officially enacted his first federal mask mandate, some experts say the U.S. should do the same. “More infectious strains require better defenses. Not more of same, better of same,” Tom Frieden, M.D., former director of the Centers for Disease Control and Prevention (CDC), said on Twitter, specifically mentioning “better masks. Surgical, N95, as available.”

To be clear, cloth masks are not totally useless. In fact, we know that mask mandates are effective at reducing the spread of COVID-19 even when the majority of people are likely wearing cloth masks. But the truth is that experts have known for some time that even multiple-layered cloth masks are not the most effective masks we have at preventing the spread of COVID-19.

“I agree with Europe. Wearing medical-grade masks will be important to slow the spread of the B.1.1.7 strain,” Atul Gawande, M.D., MPH, and member of President Biden’s COVID-19 advisory board, wrote on Twitter “We have consistent evidence that single-layer cloth masks are not as effective as surgical masks, and N95 or KN95 masks are even better.” (N95 an KN95 masks are both respirators that form a seal with the skin. While N95s are regulated by the National Institute for Occupational Safety and Health in the U.S., KN95s are regulated by Chinese authorities and imported to the U.S., the CDC explains.)

In one study, published in August of 2020, researchers tested 14 common types of face masks in a lab setting to see how many particles from a person’s mouth the masks would let through. Their results showed that—no surprise—N95 masks and surgical masks were the most effective at preventing particles from escaping. After those masks, three-layer cloth masks were the most effective, followed by a few different types of two-layer cloth masks.

This research underscores the fact that there’s a lot of variation in cloth masks—and more layers are significantly more effective. It’s also important to remember that wearing the mask properly goes a long way as well. But this study also drives home the message that, if we want maximum protection, then surgical masks and N95s are the way to go.

Even though we’ve known that surgical masks and N95s are more effective for a while, the CDC is still advising that the use of those masks should be reserved for health care workers during the pandemic due to concerns about short supply. But now that we’re a year into the pandemic and facing new coronavirus variants, experts say it’s worth re-examining our national approach to mask use—and if supply issues really are to blame, they should have been solved by now.

“To offer people better protection from contagious variants of Covid, especially Americans at higher risk because of age or infirmities, we should try to get them higher quality masks. A year into the crisis we should be able to source these for more people,” Scott Gottlieb, M.D., former commissioner for the Food and Drug Administration, wrote on Twitter.

“Every single American should have been sent N95 masks months ago,” Seema Yasmin, M.D., director of research and education at the Stanford Health Communication Initiative, wrote on Twitter. “Cloth masks should have been a stop gap measure.”

One thing that may help is that Biden intends to use the Defense Production Act to direct U.S. companies to ramp up the production of protective equipment (including N95 masks), lab equipment, and vaccine supplies. Biden also recently detailed a $1.9 trillion funding plan, which includes billions of dollars for masks and other supplies.

“Get #BetterMasks to this country,” Abraar Karan, M.D., an internal medicine physician at Brigham and Women’s Hospital and Harvard Medical School, wrote on Twitter, addressing the new administration. As we continue to adapt our strategy to new variants of COVID-19, one of our important backstop measures will be masks, he said. “We need to make sure we get the absolute best ones we can. This is our health. There should be no compromises here!”

Related:

  • Cloth Masks Do Actually Help Protect You From Coronavirus, Per the CDC
  • Researchers Tested 14 Common Face Masks—These Were the Most Effective
  • Mask Mandates Really Do Work, According to a New CDC Study

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