Myths About Face Masks

Misinformation and mixed signals about masking have spread almost as quickly as the virus. Here we've addressed six of the most common myths.

MYTH #1: Virus particles (Virions) are too small for masks to stop. Plus, there aren’t differences in face coverings, any are fine.

Respirators (N-95s) are intended to stop not just droplets, but also small particles like virions. In certain circumstances, such as being a healthcare worker caring for sick COVID-19 patients, that level of protection is necessary. When providing healthcare for symptomatic COVID-19 patients, the chance of a patient coughing, sneezing, or breathing heavily in close proximity to another person is high, therefore stricter precautions are necessary.

For our communities, including in non-healthcare business and schools, wearing cloth face masks and coverings dramatically reduce the transmission of viruses by decreasing the spread of droplets. Droplets expressed from breathing, talking, etc are the main way COVID-19 is spread in a community. The combination of social distancing, face coverings, and good hand hygiene is the best way to decrease virus transmission. According to 172 published studies of COVID-19 in communities (not hospitals), these precautions can decrease virus transmission in a community by over 70%.

Chu et al, The Lancet, June 2020    Mark Shrime, MD, PhD

There are respirators (N95s), surgical masks, cloth masks, and face shields. But these are certainly not equal. N95s will provide the biggest reduction in transmission, but also are not easily available. They are currently prioritized for hospital use. But not all N95s are the same either! Some N95s are not appropriate for healthcare use (including for the public with COVID-19). The N-95s and other masks that have vents on them are meant to be more comfortable and cause less fogging of glasses, but they do that by not restricting airflow outwards. While fine for industrial use (manufacturing, agriculture, etc), they are not as effective during a pandemic.

Acceptable masks
MYTH 2: You are breathing in a dangerous amount of CO2

Cloth facemasks and regular surgical masks allow for very small particles to pass through. The way they stop COVID-19 transmission isn’t from stopping each individual virion, but by stopping the much larger droplets that are responsible for the majority of community spread. Just as they will not stop each small virion, they also will not stop a CO2 molecule that is over 1,000x smaller than a coronavirus virion! The CO2 is allowed to escape. This is also how doctors, nurses, & other healthcare providers have been able to wear these masks for 8+ hours at a time for decades.

Myth #3: Masks cause lung damage to children.

It is not recommended for children younger than two years of age to routinely wear face masks, as they cannot necessarily communicate if they are having trouble breathing or remove the mask on their own. This is a recommendation shared by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP). Past the age of two, however, there is no established evidence of harm from the current recommendations of wearing cloth face masks.

Myth #4: If everybody doesn’t wear them, what’s the point?

It is true that the better our community practices social distancing, utilizes good hand hygiene, and wears face masks, the quicker our number of positive cases will drop. This will allow us to attend school, continuing opening up our community, and prevent unnecessary illness and death. But while we all should want to do what’s best for each other (Love thy Neighbor), we all fall short at times. With routine (not perfect) use in real-world scenarios, the daily growth rate in 15 US states decreased by 1% percent every day for the first week, and accelerated to a 2% drop each day by three weeks.

Lyu & Wehby, Health Affairs, June 2020

Myth #5: If we're socially distanced, masks aren't necessary. 
That statement is close to being true, but not quite. If a household is by themselves on a walk and unlikely to encounter anybody else, wearing masks is unlikely to reduce their risk or their community’s risk. However even being six feet away from somebody doesn’t protect them completely. In a store or business, that six feet could be reduced quickly by someone changing direction, deciding on a different purchase, etc. In school, there is frequent cause to change position (assignments, presentations, etc). The combination of wearing a face mask and social distancing when possible is far more powerful at lowering COVID-19 transmission in a group setting than either is individually
Myth #6: I already got COVID-19 so I'm immune and don't need to wear a mask.

This isn’t humankind’s first pandemic due to a coronavirus, yet we do not had a vaccine or immunization. Why? Coronaviruses are notoriously difficult to build a consistent immune response to. A recent publication in the New England Journal of Medicine from UCLA showed that COVID-19 patients that had mild or no symptoms did not mount a significant immune response and did not gain “immunity.” Those with significant symptoms built a robust immune response, however that “immunity” waned to 50% after five weeks.

Ibarrondo et al, NEJM, July 2020

Because the immunity following COVID-19 infection is not uniform nor predictable, we cannot assume that if a person has been infected in the past, they cannot infect people in the future, or contract the disease again themselves.