SARAH MCCAMMON, HOST:
This is NPR's LIFE KIT, and I'm Sarah McCammon. Masks help stop the spread of the coronavirus, so it's easy to think, yeah, I'll wear a mask all the time when I'm out in the world. But there can be lots of awkward moments. What about when you want to take a sip of water or you're exercising? NPR health correspondent Maria Godoy spoke with the experts to answer some common questions about the safety of wearing masks. Hi, Maria.
MARIA GODOY, BYLINE: Hey, Sarah.
MCCAMMON: So do we know how much mask wearing prevents the spread of the coronavirus? Is it for your own protection or is this for other people?
GODOY: It is primarily to protect other people from the wearer. And by the wearer, I literally mean the person wearing the mask because we know that people can spread the coronavirus even if they aren't showing any symptoms yet or if they never show symptoms. Even a loose-fitting surgical mask can block almost all the infectious droplets a person might emit when they're talking. But the important thing is that the more people are wearing a mask, the more everyone is protected. Your mask protects me, and mine protects you. David Aronoff is an infectious disease specialist at Vanderbilt University Medical Center. And, you know, he likens wearing a mask to wearing seat belts.
DAVID ARONOFF: You know, I would remind everybody that there was a time when seat belts weren't required by law to wear. And when people started wanting laws, there was a lot of pushback about that, about personal freedom, about how seat belts are killing people, about how seat belts aren't 100% effective, we shouldn't have to wear them. And now if you asked my children to drive a car without a seat belt or to go into a car as a passenger without a seat belt, they would feel naked without it.
MCCAMMON: So like masks, seat belts had some pushback at first. But one difference is that seat belts keep us safe individually. I put went on; I'm safer. But you were just saying, Maria, masks are mostly about protecting other people. I selfishly want to know, though, am I safer when I go out in public directly because I'm wearing a mask? Am I less likely to pick up the virus?
GODOY: A mask will offer the wearer some protection as well. How much protection really depends on what the mask is made of, how well it fits to your face and how well you are actually wearing it. It varies, but there is some protection. The important thing to remember is that masks, even an N95 respirator, which is, you know, the gold standard, what health care workers wear, even that won't offer you 100% protection. No mask is going to make you invincible. No mask is going to offer you 100% full protection. You still have to be keeping your, you know, physical distance from other people of at least 6 feet.
MCCAMMON: So we know that masks help stop the spread of the coronavirus. That's really important. But is there a downside to them? Can wearing one, for instance, limit your oxygen intake in ways that can be harmful? Is there anything that people should worry about with masks?
GODOY: You know, not for the types of cloth masks or surgical masks that the general public wears. The fibers they're made of aren't dense enough to block the exchange of gases like oxygen or carbon dioxide. And these masks aren't so tight that air can't get in around the sides. Now, there is some evidence that wearing N95 respirators for long periods of time may potentially reduce the amount of oxygen you take in but not to a dangerous extent. But those respirators seal more tightly to the face, and the risk there is really for people predisposed to breathing problems - for example, someone with emphysema - but really only medical workers should be wearing N95s right now because they're still in short supply. When it comes to cloth and surgical masks, there's really no evidence of risk to healthy people. You know, I spoke with Dr. Abraar Karan about this. He's a physician at Harvard Medical School. And he's on the Massachusetts COVID-19 response team. And here's what he said.
ABRAAR KARAN: Masks are not designed to obstruct the amount of air you're getting to that significant of a degree. And so, really, that's not a scientifically based claim.
GODOY: Now, Abraar is also a doctor at Brigham and Women's Hospital in Boston.
KARAN: So in our hospital, patients have to be masked, especially when we go to see them and stuff. If this was true - we have patients on pulse oximeters - we should see those numbers coming down if they were masked. I've never seen that, not one time.
GODOY: Now, if you find it uncomfortable to wear a mask, one thing you should do is try out different types to see what actually works for you.
MCCAMMON: Which brings us to the question - obviously, we need to reserve those N95 masks for medical workers. But aside from that, what is better - a general surgical mask, cloth mask? What's the safest?
GODOY: So, first of all, a mask is only useful if you actually wear it. And that's really the most important thing to remember. That said, there is a lot more research on surgical masks than cloth masks. And as I mentioned before, there's good research showing that surgical masks can block most of the infectious droplets that are emitted by the person wearing it. Now, if you're talking about a surgical mask versus a single-layer cloth mask made of thin fabric, yeah, that surgical mask is almost certainly going to give you more protection. Until now, there really hadn't been much research done on cloth masks. But the studies that have been done since the pandemic began suggest that, you know, depending on what kind of fabric you use, the shape of the mask, how many layers of fabric it has, if it has a filter, how well it fits to your face, et cetera, you can get a cloth mask with pretty decent filtration efficiencies. I actually wrote a whole guide about this. It's on npr.org.
But the bottom line is, you know, regardless of whether you're wearing a cloth mask or a surgical mask, you can't think that now you're invincible. You know, they're not giving you full protection. You can't suddenly be in prolonged close contact with people. You should think of these masks as buying you a few extra minutes of protection, not hours. So you still need to be physically distancing, you know, keeping at least 6 feet away from others. But when you combine masks with other measures like distancing and hand-washing and avoiding crowds, you can really cut down on transmission of the virus. If we go back to our seat belt analogy, is a seat belt going to prevent all deaths from car crashes? No. But are you better off wearing a seat belt than not, yes? Same thing goes with masks.
MCCAMMON: And, Maria, what about people with serious respiratory conditions? I mean, should - is it safe for them to wear masks?
GODOY: You know, actually, doctors say people with these conditions especially need to be masking up in public because they're at greater risk for severe disease if they get COVID-19. You know, even someone who relies on oxygen, when they go out in public, can wear a loose-fitting cloth or surgical mask over their cannula. That's, you know, that tube that delivers air under their nose. I talked about it with Dr. Aronoff, and here's what he said.
ARONOFF: Many people with preexisting lung disease absolutely can wear a cloth mask. But if there are people with chronic lung conditions who either are not comfortable wearing a mask or perceive that it's really making them more anxious or short of breath or it really is challenging their ability to breathe, then I think another good option for them is to use a transparent, plastic face shield.
GODOY: Now, he's actually talking about plastic shields that attach the top of your head, and they go down past your chin and curve around your ears. And they can block a lot of incoming respiratory droplets. But it's not yet known how well they protect other people from the wearer.
MCCAMMON: Let's talk about exercise. Lots of huffing and puffing if you're out running or exercising in some other way. Is there a risk that if you're wearing a mask, you won't be able to catch your breath?
GODOY: Yeah, that's a totally legitimate concern. If you're doing something like running or biking outdoors and you're alone or just with the people you live with, it's totally OK to have your mask down if there's no one else around. And as long as you haven't been touching stuff along the way, like benches or rails, you haven't had a close conversation with a stranger, you know, it's OK to use your hands to pull it down. If you see someone coming, pull up your mask again until they pass. And if you're running and passing someone, give them at least 6 feet of space. Now, indoor gyms are tricky because we know people who breathe heavily are likely to expel more respiratory droplets. And they aren't going to disperse as quickly as they would outdoors. So the risks are much higher indoors.
When I spoke with Abraar, he said he's taken advantage of the warmer weather, and he's moved all his workouts outdoors. So he's personally not going to the gym, even though they're beginning to open up. And, you know, I am someone who loves to workout. I love going to the gym. I love going to classes. But I also know that outbreaks have been linked to indoor fitness classes, specifically to higher intensity exercise classes where people are breathing more heavily. So you really have to weigh the risk of working out inside a gym for yourself. And if you do, I would avoid high intensity exercise because it's going to be a lot harder to breathe through your mask. And I would space out a lot, at least 6 feet, but, really, I think 12 feet is a better idea. But all the experts I've spoken with say your best bet right now is to workout at home or outdoors.
MCCAMMON: Yeah. When we're wearing these around, they get dirty. They're exposed to the air. We do sweat. How often do you need to be washing them? And what should you be doing with those dirty masks?
GODOY: Yeah. You know, David Aronoff has some good advice on that, too.
ARONOFF: People should wash their mask at least every day. It's fine to wash it by hand with soap and water or with laundry detergent or put it in a washing machine. And these masks can be air dried or they can be put into a dryer on high heat. But however they get clean, that's the most important thing.
GODOY: You know, it's also a good idea to have several cloth masks that you can rotate in and out so you don't have to wash just one every day.
MCCAMMON: A lot of people do find masks uncomfortable. They're hot, especially in the summertime. They make some people feel really anxious when they put them on. Is it OK to take a break from wearing a mask? Like, what if you need to take a drink of water or you're just tired of wearing it and nobody's around?
GODOY: Yeah, it's totally OK to take periodic breaks from wearing a mask. Just make sure you do it when no one else is around, so, you know, maybe step outside. There is a right way to take off a mask. Don't touch the front of the mask when you take it off so you don't actually touch any infectious droplets that it might have blocked. Instead, take it off by the ear loops. To be clear, you wouldn't want to touch your mask if you're indoors like in a store where your fingers might have come into contact with virus droplets on objects that other shoppers touched. But if you're outdoors and you're solo, you haven't been touching stuff along the way, you haven't had a close chat with someone, it's OK to pull down your mask. As Dr. Abraar Karan told me, nobody is 100% perfect with this stuff.
KARAN: How many people do anything 100% of the time? Almost none, right? We're not perfect. We're not going to be doing - I - you know, we all miss things, you know? It's not easy. Even taking, like, one pill a day is not easy. It's not an easy thing to do for a long time.
GODOY: You know, Abraar says we all just need to do the best we can. And even if we're not 100% perfect with our masking technique, if most of us are wearing masks in public, we can make a big difference in slowing the spread of the coronavirus.
MCCAMMON: It's all about risk mitigation and reduction it sounds like.
MCCAMMON: Well, thank you so much, Maria.
GODOY: My pleasure.
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MCCAMMON: For more episodes of LIFE KIT, go to npr.org/lifekit. We have episodes on all sorts of topics, from how to manage uncertainty to how to get out of debt. If you love LIFE KIT and want more, subscribe to our newsletter at npr.org/lifekitnewsletter. Also we want to hear your random tips. Leave us a voicemail at 202-216-9823. Or email us at firstname.lastname@example.org. This episode was produced by Clare Schneider. Meghan Keane is the managing producer. And Beth Donovan is our senior editor. I'm Sarah McCammon. Thanks for listening.
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GODOY: OK. Sorry. My 6-year-old was literally doing parkour on our furniture.
MCCAMMON: I mean, why not?
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